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Copyright, 1920, 
By Little, Brown, and Company. 

All rights reserved 
Published November, 1920 

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Set up and electrotyped by J. S. Cushing Co. 

Norwood, Mass., U. S. A. 




I Introductory 1 

II The Nature of "Nervousness" . . 17 
III Types of Housewife Predisposed to 

Nervousness 46 

XV The Housework and the Home as 

Factors in the Neurosis . 
V Reaction to the Disagreeable . 
VI Poverty and Its Psychical Results 
VII The Housewife and Her Husband 
VIII The Housewife and Her Household 

Conflicts 141 

IX The Symptoms as Weapons against the 

Husband 160 

X Histories of Some Severe Cases . 168 
XI Other Typical Cases .... 199 
XII Treatment of the Individual Cases . 231 
XIII The Future of Woman, the Home, and 

Marriage 244 

Index 269 




How old is the problem of the Nervous 
Housewife ? 

Did the semi-mythical Cave Man (who is 
perhaps only a pseudo-scientific creation) on 
his return from a prehistoric hunt find his 
leafy spouse all in tears over her staglocythic 
house-cleaning, or the conduct of the youngest 
cave child? Did she complain of her back, 
did she have a headache every time they 
disagreed, did she fuss and fret until he lost 
his patience and dashed madly out to the 
Cave Man's Refuge? 

We cannot tell; we only know that all 
humor aside, and without reference to the 
past, the Nervous Housewife is surely a 
phenomenon of the present-day American 
home. In greater or less degree she is in 



every man's home ; nor is she alone the rich 
Housewife with too little to do, for though 
riches do not protect, poverty predisposes, 
and the poor Housewife is far more frequently 
the victim of this disease of occupation. 
Every practicing physician, every hospital 
clinic, finds her a problem, evoking pity, con- 
cern, exasperation, and despair. She goes 
from specialist to specialist, — orthopedic 
surgeon, gynecologist, X-ray man, neurolo- 
gist. By the time she has completed a course 
of treatment she has tasted all the drugs in 
the pharmacopeia, wears plates on her feet, 
spectacles on her nose, has had her teeth 
tinkered with, and her insides straightened; 
has had a course in hydrotherapeutics, elec- 
trotherapeutics, osteopathy, and Christian 
Science ! 

Such is an extreme case ; the minor cases 
pass through life burdened with pains and 
aches of the body and soul. And one of 
the commonest and saddest of transforma- 
tions is the change of the gay, laughing 
young girl, radiant with love and all aglow 
at the thought of union with her man, into 
the housewife of a decade, — complaining, 
fatigued, and disillusioned. Bound to her 


husband by the ties the years and the chil- 
dren have brought, there is a wall of mis- 
understanding between them. 

"Men don't understand," cries she. 
"Women are unreasonable," says he. 

What are the causes of the change? Did 
the housewife of a past generation go through 
the same stage ? Ask any man you meet 
and he will tell you his mother is or was 
more enduring than his wife. "She bore 
three times as many children ; she did all 
her own housework ; she baked more, cooked 
more, sewed more ; she got up at five o'clock 
in the morning and went to bed at ten at 
night; she never went out, never had a 
vacation, did not know the meaning of mani- 
cure, pedicure, coiffure. She was contented, 
never extravagant, and rarely sick." 

So the average man will say, and then : 
"Those were the good old days of simple 
living, gone like the dodo ! To-day, — well, 
it reminds me of a joke I heard. One man 
meets another and says : ' By the way, I 
heard that your wife was the champion 
athlete at college.' 'Ah, yes,' said the 
husband; 'now she is too weak to wash the 


Is the average man's impression the correct 
one ? Or are we dealing with the incorrigible 
disposition of man to glorify the past? To 
the majority of people their youth was an era 
of stronger, braver men, more wholesome, 
beautiful women. People were better, times 
were more natural, and there is a grim satis- 
faction in predicting that the "world is 
going to the dogs." "The good old days" 
has been the cry of man from the very earliest 

Yet read what a contemporary of the 
housewife of three quarters of a century ago 
says, — the wisest, wittiest, sanest doctor 
of the day, Oliver Wendell Holmes. The 
genial autocrat of the breakfast table ob- 
serves : "Talk about military duty! What 
is that to the warfare of a married maid of 
all work, with the title of mistress and an 
American female constitution which collapses 
just in the middle third of life, comes out 
vulcanized India rubber, if it happens to 
live through the period when health and 
strength are most wanted?" 

And then, if one looks in the advertisements 
of half a century ago, one finds the nostrum 
dealer loudly proclaiming his capacity to cure 


what is evidently the Nervous Housewife. 
In America at least she has always existed, 
perhaps in lesser numbers than at present. 
And one remembers in a dim sort of way that 
the married woman of olden days was al- 
together faded at thirty-five, that she entered 
on middle life at a time when at least many 
of our women of to-day still think themselves 

It becomes interesting and necessary at 
this point to trace the evolution of the home, 
because this is to trace the evolution of our 
housewife. We are apt to think of the home 
as originating in a sort of cave, where the 
little unit — the Man, the Woman, and the 
Children — dwelt in isolation, ever on the 
watch against marauders, either animal or 
human. In this cave the woman was the 
chattel of man; he had seized her by force 
and ruled by force. 

Perhaps there was such a stage, but much 
more likely the home was a communal 
residence, where the man-herd, the group, 
the clan, the Family in the larger sense dwelt. 
Only a large group would be safe, and the 
strong social instinct, the herd feeling, was 
the basis of the home. Here the men 


and women dwelt in a promiscuity that 
through the ages went through an evolution 
which finally became the father-controlled 
monogamy of to-day. Here the women lived ; 
here they span, sewed, built; here they 
started the arts, the handicrafts, and the 
religions. And from here the men went 
forth to fish and hunt and fight, grim males 
to whom a maiden was a thing to court and 
a wife a thing to enslave. 

Just how the home became more and more 
segregated and the family life more in- 
dividualized is not in the province of this 
book to detail. This is certain : that the 
home was not only a place where man and 
woman mated, where their children were 
born and reared, where food was prepared 
and cooked, and where shelter from the ele- 
ments was obtained ; it was also the first great 
workshop, where all the manifold industries 
had their inception and early development. 
The housewife was then not only mother, 
wife, cook, and nurse ; she was the spinner, 
the weaver, the tanner, the dyer, the brewer, 
the druggist. 

Even in the high civilization of the Jews 
this wide scope of the housewife prevailed. 


Read what the wisest, perhaps because 
most married, of men says : 

She seeketh wool and flax, . 

And worketh willingly with her hands. 

She is like the merchant ships ; 

She bringeth her food from afar. 

She considereth a field, and buyeth it. 

With the fruit of her hands she planteth a vineyard. 

She girdeth her loins with strength, 

And maketh strong her arms. 

She perceiveth that her merchandise is good. 

Her lamp goeth not out by night. 

She layeth her hands to the distaff 

And her hands hold the spindle. 

She is not afraid of the snow for her household : 
For all her household are clothed with scarlet. 
She maketh for herself coverlets, 
She maketh linen garments and selleth them, 
And delivereth girdles unto the merchants. 

No wonder "her children rise up and call 
her blessed" and it is somewhat conde- 
scending of her husband when he "praiseth 
her." All we learn of him is that he "is 
known in the gates when he sitteth among 
the elders of the land." With a wife like 
her, this was all he had to do. 

This combination of industrialism and 


domesticity continued until gradually men 
stepped into the field of work, perhaps as a 
result of their wives' example, and became 
farmers on a larger scale, merchants of a 
wider scope, artisans, handicraftsmen, guild 
members of a more developed technique. 
Woman started these things in the home or 
near it; man, through his restless energy, 
specialized and thus developed an intenser 
civilization. But even up till the nineteenth 
century woman carried on all her occupations 
at the home, which still continued to be work- 
shop and hearth. 

Then man invented the machine, harnessed 
steam, wired electricity, and there was born 
the Factory, the specialized house of industry, 
in which there works no artisan, only factory 
hands. The home could not compete with 
this man's monster, into which flowed one 
river of raw material and out of which poured 
another of finished products. But not only 
did the factory dye, weave, spin, tan, etc. ; 
it also invaded the innermost sphere of 
woman's work. For her loaf of bread it 
turned out thousands, until finally she is 
beginning to give up baking; for her hit- 
or-miss jellies, preserves, jams, it invented 


scientific canning with absolute methods, 
handy forms, tempting flavors. And canning 
did not stop there ; meats, soups, vegetables, 
fruits are now placed in the hands of the 
housewife "Ready to Serve," until the cynical 
now state, "Woman is no longer a cook, she 
is a can opener." With all the talk in this 
modern time of women invading man's field, 
it is just to remark that man has stepped into 
woman's work and carried off a huge part of 
it to his own creation, the factory. 

Thus it has come to pass that in our day the 
housewife does but little dyeing, spinning, 
weaving, is no longer a handicraftsman, and 
in addition is turning over a large part of her 
food preparation and cooking to the factory. | 

But the factory is not content with thus 
disarranging the ancient scheme of things by 
invading the housewife's province; it has 
dragged a large number of women, yearly 
increasing in number and proportion, into 
industry. Thus it has made this condition 
of affairs : that it takes the young girl from 
the home for the few years that intervene 
before her marriage. She is thus initiated 
into wage-earning before she becomes a 
man's wife, the housewife. 


This industrial period of a girl's life is 
important psychologically, for it profoundly 
influences her reaction to her status and work 
as homekeeper. 

Of even greater importance to our study 
than the influence of the factory is the rise 
of what is known as feminism. Of all the 
living creatures in the world the female of 
the human species has been the most down- 
trodden, for to every wretched class of man 
there was a still inferior, more wretched 
group, their wives. She was a slave to the 
slaves, a dependent of the abjectly poor. 
When men passed through the stage where 
woman's life might be taken at a whim, she 
remained a creature without rights of the 
wider kind. Men debated whether she had 
a soul, made cynical proverbs about her, 
called her the "weaker vessel," and debarred 
her from political and economic equality, 
classing her up to this very moment in rights 
with the idiot, the imbecile, and the criminal. 
Worse than this, they gave her a spurious 
homage, created a lop-sided chivalry, and 
caused her to accept as her ideal goal of 
womanhood the achievement of beauty and 
the entrance into wifehood. After they tied 


her hand and foot with restrictions and be- 
littling ideals, they capped the climax by 
calling her weak and petty by nature and 
even got her to believe it ! 

It is not my intention to trace the rise of 
feminism. Brave women arose from age to 
age to glorify the world and their sex, 
and men here and there championed them. 
Man started to emancipate himself from 
slavery, and noble ideals of the equality of 
mankind first were whispered, then shouted 
as battle cries, and finally chiseled with 
enduring letters into the foundations of 
States. "But if all this was good for men, 
why not for women — why should they be 
fettered by illiteracy, pettiness, dependence; 
why should they be voiceless in the state 
and world?" So asked the feminists. The 
factory called for women as labor; they be- 
came the clerks, the teachers, the typists, 
the nurses. Medicine and the law opened 
their doors, at least in part. And now we are 
on the verge of universal suffrage, with women 
entering into the affairs of the world, theo- 
retically at least the equals of man. 

But with the entrance of woman into many 
varied professions and occupations, with a 


wider access to experience and knowledge, 
arose what may be called the era of the 
"individualization of woman." For if any 
group of people are kept under more or less 
uniform conditions in early life, if one goal 
is held out as the only legitimate aim and 
end, in a word, if their training and purposes 
are made alike, they become alike and in- 
dividuality never develops. With individual- 
ity comes rebellion at old-established con- 
ditions, dissatisfaction, discontent, and espe- 
cially if the old ideal still remains in force. 
This new type of woman is not so well fitted 
for the old type of marriage as her prede- 
cessors. There arises a group of consequences 
based psychologically on this, a fact which we 
shall find of great importance later on. 

Women still regard marriage as their chief 
goal in life, still enter homes, still bear chil- 
dren, and take their husband's name. But 
having become more individualized they 
demand more definite individual treatment 
and rebel more at what they consider an 
infringement of their rights as human beings. 
Also, and unfortunately, they still wish the 
right to be whimsical, they continue to re- 
serve for themselves the weapons of tears, 


reproaches, and unreasonable demands. This 
has brought about the divorce evil. 

Briefly the "divorce" evil arises first from 
the rebellion of woman against marital 
drunkenness, unfaithfulness, neglect, brutal- 
ity that a former generation of wives tolerated 
and even expected. Second, it arises from a 
conflict between the institution of marriage 
which still carries with it the chattel idea — 
that woman is property — and a generation 
of women that does not accept this. Third, 
it arises from the ill-balanced demands of 
women to be treated as equals and also as 
irresponsible, petty, and indulged tyrants. 
Men are unable to adjust themselves to the 
shattering of the romantic ideal, and the home 
disintegrates. Though divorce is the top of 
the crest of marital unhappiness, it really rep- 
resents only the extreme cases, and behind it is 
a huge body of quarreling and divided homes. 

We shall later see that our Nervous House- 
wife has symptoms and pains and aches and 
changes in mood and feeling that are born 
of the conflict that is in part pictured by 
divorce. Divorce is a manifestation of the 
discontent of women, and so is the nervousness 
of the housewife. 




There arises as a result of this individual- 
ization of woman, as a result of increasing 
physiological knowledge, the hugely important 
fact of restricted child bearing. The woman 
will no longer bear children indiscriminately, 
— and the large family is soon to be a thing 
of the past in America and in all the civilized 
world. The-woman-that-knows-how shrinks 
from the long nine months of pregnancy, the 
agony of the birth, and the weary restricted 
months of nursing. Had the woman of a 
past time known how, she too would have 
refused to bear. In this the housewife of 
to-day is seconded by her husband, for where 
he has sympathy for his wife he prefers to 
let her decide the number of children, and 
also he is impressed by the high cost of rear- 
ing them. 

One gets cynical about the influence of 
church, patriotism, and press when one sees 
how the housewife has disregarded these 
influences. For all the religions preach that 
race suicide is a sin, all the statesmen point 
out that only decadent nations restrict 
families, and all or nearly all the press thunder 
against it. It is even against the law for a 
physician or other person to instruct in the 


methods of birth restriction, and yet — the 
birth rate steadily drops. An immigrant 
mother has six, eight, or ten children and her V 
daughter has one, two, or three, very rarely 
more, and often enough none. This is true 
even of races close to religious teaching, such 
as the Irish Catholic and the Jew. 

One can well be cynical of the power of 
religion and teaching and law when one finds 
that even the families of ministers, rabbis, 
editors, and lawmakers, all of whom stand 
publicly for natural birth, have shown a great 
reduction in their size, that has taken place 
in a single generation. 

Is the modern woman more susceptible to 
the effects of pregnancy, — less resistant to 
the strain of childbearing and childbirth? 
It is a quite general impression amongst 
obstetricians that this is a fact and also that 
fewer women are able to nurse their babies. 
If so, these phenomena are of the highest 
importance to the race and likewise to the 
problem of the new housewife. For we shall 
learn that the lowering of energy is both a 
cause aftd symptom of her neuroses. 

If then we summarize what has been thus 
far outlined, we find two currents in the 


evolution of the housewife. First, she has 
yielded a large part of her work to the factory, 
practically all of that part of it which is 
industrial and a considerable portion of the 
food preparation. 

Second, there has been a rise in the dignity 
and position of woman in the past one hundred 
and fifty years which has had many results. 
She has considerably widened the scope of 
her experience with life through work in the 
factory, in the office, in the schoolhouse, and 
in the professions. This has changed her 
attitude toward her original occupation of 
housewife and is a psychological fact of great 
importance. She has become more indus- 
trial and individualized, and as a result has 
declined to live in unsatisfactory relations with 
man, so that divorce has become more fre- 
quent. In part this is also caused by her 
inability to give up petty irresponsibility while 
claiming equality. Finally, the declining birth 
rate is still further evidence of her individual- 
ization and is in a sense her denial of mere 
femaleness and an affirmation of freedom. 


The Nature of "Nervousness" 

Preliminary to our discussion of the ner- 
vousness of the housewife we must take up 
without great regard to details the subject of 
nervousness in general. 

Nervousness, like many another word of 
common speech, has no place whatever in 
medicine. Indeed, no term indicating an 
abnormal condition is so loosely used as this 

People say a man is nervous when they 
mean he is subject to attacks of anger, an 
emotional state. Likewise he is nervous 
when he is a victim of fear, a state literally 
the opposite of the first. Or, if he is restless, 
is given to little tricks like pulling at his 
hair, or biting his nails, he is nervous. The 
mother excuses her spoiled child on the 
ground of his nervousness, and I have seen 
a thoroughly bad boy who branded his 


baby sister with a heated spoon called 
"nervous." A "nervous breakdown** is a 
familiar verbal disguise for one or other 
of the sinister faces of insanity itself. 

It should be made clear that what we are 
dealing with in the nervous housewife is 
not a special form of nervous disorder. It 
conforms to the general types found in single 
women and also in men. It differs in the 
intensity of symptoms, in the way they group 
themselves, and in the causes. 

Physicians use the term psyehoneuroses to 
include a group of nervous disorders of so-called 
functional nature. That is to say, there is no 
alteration that can be found in the brain, 
the spinal cord, or any part of the nervous 
system. In this, these conditions differ from 
such diseases as locomotor ataxia, tumor of 
the brain, cerebral hemorrhage, etc., be- 
cause there are marked changes in the struc- 
ture in the latter troubles. One might com- 
pare the psyehoneuroses to a watch which 
needed oiling or cleaning, or merely a winding 
up. — as against one in which a vital part 
was broken. 

The most important of the psyehoneuroses, 
in so far as the housewife is concerned, is the 


condition called neurasthenia, although two 
other diseases, psychasthenia and hysteria, 
are of importance. 

It is interesting that neurasthenia is con- 
sidered by many physicians as a disease of 
modern times. Indeed, it was first described 
in 1S69 by the eminent neurologist Beard, 
who thought it was entirely caused by the 
stress and strain of American life. That not 
only America, but every part of the whole 
civilized world has its neurasthenia is now 
an accepted fact. Knowing what we do of 
its causes we infer that it is probably as old 
as mankind ; but there exists no reasonable 
doubt that modern life, with its hurry, its 
tensions, its widespread and ever present 
excitement, has increased the proportion of 
people involved. 

Particularly the increase in the size and 
number of the cities, as compared with the 
country, is a great factor in the spread of 
neurasthenia. Then. too. the introduction 
of so-called time-saving, i.e. distance-annihi- 
lating instruments, such as the telephone, 
telegraph, railroad, etc., have acted not 90 
much to save time as to increase the number 
of things done, seen, and heard. The busy 


man with his telephone close at hand may be 
saving time on each transaction, but by 
enormously increasing the number of his 
transactions he is not saving himself. 

The keynote of neurasthenia is increased 
liability to fatigue. The tired feeling that 
comes on with a minimum of exertion, worse 
on arising than on going to bed, is its dis- 
tinguishing mark. Sleep, which should re- 
move the fatigue of the day, does not; the 
victim takes half of his day to get going; 
and at night, when he should have the de- 
licious drowsiness of bedtime, he is wide- 
awake and disinclined to go to bed or sleep. 
This fatigue enters into all functions of the 
mind and body. Fatigue of mind brings 
about lack of concentration, an inattention; 
and this brings about an inefficiency that 
worries the patient beyond words as por- 
tending a mental breakdown. Fatigue of 
purpose brings a listlessness of effort, a 
shirking of the strenuous, the more distressing 
because the victim is often enough an idealist 
with over-lofty purposes. Fatigue of mood 
is marked by depression of a mild kind, a 
liability to worry, an unenthusiasm for those 
one loves or for the things formerly held 


dearest. And finally the fatigue is often 
marked by a lack of control over the emo- 
tional expression, so that anger blazes forth 
more easily over trifles, and the tears come 
upon even a slight vexation. To be neuras- 
thenic is to magnify the pins and pricks of 
life into calamities, and to be the victim of 
an abnormal state that is neither health nor 

The more purely physical symptoms con- 
stitute almost everything imaginable. 

1. Pains and aches of all kinds stand 
out prominently; headache, backache, pains 
in the shoulders and arms, pains in the 
feet and legs, pains that flit here and there, 
dull weary pains, disagreeable feelings rather 
than true pains . These pains are frequently 
related to disagreeable experiences and 
thoughts, but it is probable that fatigue 
plays the principal part in evoking them. 

2. Changes in the appetite, in the condition 
of the stomach and bcwels, are prominent. 
Loss of appetite is complained of, or more 
often a capricious appetite, vanishing quickly, 
or else too easily satisfied. The capricious- 
ness of appetite is undoubtedly emotional, 
for disagreeable emotions, such as worry, 


fear, vexation, have long been known as the 
chief enemies of appetite. 

With this change of appetite goes a host of 
disorders manifested by "belching", "sour 
stomach", "logy feelings", etc. What is 
back of these lay terms is that the tone, move- 
ment, and secreting activity of the stomach 
is impaired in neurasthenia. When we con- 
sider later on the nature of emotion, we shall 
find these changes to be part of the disorder 
of emotion. 

3. So, too, there is constipation. In how 
far the constipation is primary and in how 
far it is secondary is a question. At any rate, 
once it is established, it interferes with all 
the functions of the organism by its interfer- 
ence with the mood. 

The following story of Voltaire bluntly 
illustrates a fact of widespread knowledge. 
Voltaire and an Englishman, after an intimate 
philosophical discussion, decided that the 
aches and pains of life outnumbered the agree- 
able sensations, and that to live was to endure 
unhappiness. Therefore, they decided that 
jointly they would commit suicide and named 
the time and the place. On the day appointed 
the Englishman appeared with a revolver 


ready to blow out his brains, but no Voltaire 
was to be seen. He looked high and low 
and then went to the sage's home. There 
he found him seated before a table groaning 
with the good things of life and reading a 
naughty novel with an expression of utmost 
enjoyment. Said the Englishman to Vol- 
taire, "This was the day upon which we 
were to commit suicide." "Ah, yes," said 
Voltaire, "so we were, but to-day my bowels 
moved well." 

4. The disturbed sleep, either as insomnia 
or an unrestful, dream-disturbed slumber, 
is a distressing symptom. For we look to the 
bed as a refuge from our troubles, as a sanc- 
tuary wherein is rebuilded our strength. 
We may link work and sleep as the two com- 
plementary functions necessary for happiness. 
If sleep is disturbed, so is work, and with that 
our purposes are threatened. So disturbed 
sleep has not only its bodily effects but has 
its marked results on our happiness. 

5. Fundamental in the symptoms of 
neurasthenia is fear. This fear takes two 
main forms. First, the worry over the life 
situation in general, that is to say, fear con- 
cerning business ; fear concerning the health 


and prosperity of the household; fear that 
magnifies anything that has even the faintest 
possibility of being direful into something 
that is almost sure to happen and be dis- 
astrous. This constant worry over the possi- 
bilities of the future is both a cause of neu- 
rasthenia and a symptom, in that once a 
neurasthenic state is established, the liability 
to worry becomes greatly increased. 

Second, there is a special form of worry 
called by the old authors hypochondriacism, 
which essentially is fear about one's own 
health. The hypochondriac magnifies every 
flutter of his heart into heart disease, every 
stitch in his side into pleurisy, every cough 
into tuberculosis, every pain in the abdomen 
into cancer of the stomach, every headache 
into the possibility of brain tumor or in- 
sanity. He turns his gaze inward upon 
himself, and by so doing becomes aware of 
a host of sensations that otherwise stream 
along unnoticed. Our vision was meant for 
the environment, for the world in which we 
live, since the bodily processes go on best un- 
noticed. The little fugitive pains and aches ; 
the little changes in respiration; the rum- 
blings and movements of the gastro-intestinal 


tract have no essential meaning in the 
majority of cases, but once they are watched 
with apprehension and anxiety, they multiply 
extraordinarily in number and intensity. 
One of the cardinal groups of symptoms in a 
neurasthenic is this fear of serious bodily 
disease for which he seeks examination and 
advice constantly. Naturally enough, he be- 
comes the choicest prey for the charlatan, 
the faker, or perhaps ranks second to the 
victim of venereal or sexual disease. The 
faker usually assures him that he has the 
disorders he fears and then proceeds to cure 
him by his own expensive and marvelous 
course of treatment. 

What has been sketched here is merely the 
outside of neurasthenia. Back of it as causa- 
tive are matters we shall deal with in detail 
later on in relation to the housewife, — 
matters like innate temperament, bad train- 
ing, liability to worry, wounded pride, failure, 
desire for sympathy, monotony of life, bore- 
dom, unhappiness, pessimism of outlook, 
over-aesthetic tastes, unfulfilled and thwarted 
desires, secret jealousy, passions and long- 
ings, fear of death, sex problems and diffi- 
culties and doubt; matters like recent ill- 


ness, childbirth, poverty, overwork, wrong 
sex habits, lack of fresh air, etc. 

Fundamentally neurasthenia is a deener- 
gization. By this is meant that either there 
is an actual reduction in the energy of the 
body (as after a sickness, pregnancy, etc.) 
or else something impedes the discharge of 
energy. This latter is usually an emotional 
matter, or arises from some thought, some 
life situation of a depressing kind. 

It is necessary and important thai we con- 
sider these two aspects of our subject a little 
closer, not so much as regards the housewife, 
but over the wider field of the human being. 

The human being, like every living thing, 
is an instrument for the building up and 
discharge of energy. He takes in food, the 
food is digested (made over into certain sub- 
stances) and these are built up into the tissues, 
— and then their energy is discharged as 
heat and as motion. The heat is the body 
temperature, the motion is the movement of 
the human body in all the marvelous variety 
of which it is capable. In other words, the 
discharge of energy is the play of our child- 
hood and of our later years; it is the skill 
and strength of our arms, the cleverness of 


our hands, the fleetness of our feet, the 
joyous vigor of our love-making, the em- 
brace ; it is the noble purpose, the long, 
hard-fought battles of any kind. It is all 
that is summed up in desire, purpose, and 

Now all these things may be impeded by 
actual reduction of energy, as in tubercu- 
losis, cancer, or in the lassitude of con- 
valescence. In addition there are emotions, 
feelings, thoughts that energize, — that create 
vigor and strength of body and mind. Joy 
rouses the spirit; one dances, laughs, sings, 
shouts; or the more quiet type of person 
takes up work with zeal and renewed energy. 
Hope brings with it an eagerness for the battle, 
a zest for work. The glow of pride that 
comes with praise is a stimulus of great 
power and enlarges the scope of the personal- 
ity. The feeling that comes with successful 
effort, with rewarded effort, is a new birth of 
purpose and will. And whatever arouses the 
fighting spirit, which in the last analysis is 
based on anger, achieves the same end. 

There are deenergizing emotions and expe- 
riences as well, things that suddenly rob the 
victim of strength and purpose. Fear of a 


certain type is one of these things, as when 
one's knees knock together, the limbs become 
as it were without the control of the will, 
the heart flutters, and the voice is hoarse 
and weak. Fear of sickness, fear of death, 
either for one's self or some beloved one, may 
completely deenergize the strongest man. 
Then there is hope deferred, and disappoint- 
ment, the frustration of desire and purpose, 
helplessness before insult and injustice, blame 
merited or unmerited, the feeling of failure 
and inevitable disaster. There is the un- 
happy life situation, — the mistaken mar- 
riage, the disillusionment of betrayed love, the 
dashing of parental pride. The profoundest 
deenergization of life may come from a 
failure of interest in one's work, a boredom 
due to monotony, a dropping out of enthu- 
siasm from the mere failure of new stimuli, as 
occurs with loneliness. Any or all of these 
factors may bring about a neurasthenic, de- 
energized state with lowering of the functions 
of mind and body. We shall discover how 
this comes about farther on. 

What part does a subconscious personality 
take in all this and in further symptoms? 
Is there a subconsciousness, and what is it? 


In answer, the majority of modern psy- 
chologists and psychopathologists affirm the 
existence of a subconscious personality. One 
needs only mention James, Janet, Ribot, 
McDougall, Freud, Prince, out of a host of 
writers. Whether they are right or not, 
or whether we now deal with a new fashion in 
mental science, this can be affirmed — that 
every human being is a pot boiling with 
desires, passions, lusts, wishes, purposes, ideas, 
and emotions, some of which he clearly rec- 
ognizes and clearly admits, and some of 
which he does not clearly recognize and which 
he would deny. 

These desires, passions, purposes, etc., are 
not in harmony one with another; they are 
often irreconcilable and one has to be 
smothered for the sake of the other. Thus 
a sex feeling that is not legitimate, an illicit 
forbidden love has to be conquered for the 
sake of the purpose to be religious or good, or 
the desire to be respected. So one may struggle 
against a hatred for a person whom one should 
love, — - a husband, a wife, an invalid parent, 
or child whose care is a burden, and one 
refuses to recognize that there is such a 
struggle. So one may seek to suppress jeal- 


ousy, envy of the nearest and dearest ; soul- 
stirring, forbidden passions; secret revolt 
against morality and law which may (and 
often do) rage in the most puritanical breast. 

In the theory of the subconscious these 
undesired thoughts, feelings, passions, wishes, 
are repressed and pushed into the innermost 
recesses of the being, out of the light of the 
conscious personality, but nevertheless acting 
on the personality, distorting it, wearying it. 

However this may be, there is struggle, 
conflict in every human breast and especially 
difficult and undecided struggles in the case 
of the neurasthenic. Literally, secretly or 
otherwise, he is a house divided against 
himself, deenergized by fear, disgust, revolt, 
and conflict. 

And the housewife we are trying to under- 
stand is particularly such a creature, with a 
host of deenergizing influences playing on 
her, buffeting her. Our aim will be to analyze 
these influences and to discover how they 

I have stated that in medical practice two 
other types are described, — psychasthenia 
and hysteria. These are not so definitely 
related to the happenings of life as to the 


inborn disposition of the patient. Nor are 
they quite so common in the housewife as 
the neurasthenic, deenergized state. How- 
ever, they are usually of more serious nature, 
and as such merit a description. 

By the term psychasthenia is understood 
a group of conditions in which the bodily 
symptoms, such as fatigue, sleeplessness, loss 
of appetite, etc., are either not so marked 
as in neurasthenia, or else are overshadowed 
by other, more distinctly mental symptoms. 

These mental symptoms are of three main 
types. There is a tendency to recurring 
fears, — fears of open places, fears of closed 
places, fear of leaving home, of being alone, 
fear of eating or sleeping, fear of dirt, so that 
the victim is impelled continually to wash the 
hands, fear of disease — especially such as 
syphilis — and a host of other fears, all of 
which are recognized as unreasonable, against 
which the victim struggles but vainly. Some- 
times the fear is nameless, vague, undifferen- 
tiated, and comes on like a cloud with rapid 
heartbeat, faint feelings, and a sense of impend- 
ing death. Sometimes the fear is related to 
something that has actually happened, as, fear 
of anything hot after a sunstroke; or fear 


of any vehicle after an automobile acci- 

There is also a tendency to obsessive ideas 
and doubts; that is, ideas and doubts that 
persist in coming against the will of the 
patient, such as the obscene word or phrase 
that continually obtrudes itself on a chaste 
woman, or the doubt whether one has shut 
the door or properly turned off the gas. Of 
course, everybody has such obsessions and 
doubts occasionally, but to be psychasthenic 
about it is to have them continually and to 
have them obtrude themselves into every 
action. In extreme psychasthenia the diffi- 
culty of "making up the mind", of deciding, 
becomes so great that a person may suffer 
agonies of internal debate about crossing the 
street, putting on his clothes, eating his meals, 
doing his work, about every detail of his 
coming, going, doing, and thinking. A rest- 
less anxiety results, a fear of insanity, an 
inefficiency, and an incapacity for sustained 
effort that results in the name that is often 
applied, — "anxiety neurosis." 

Third, there is a group of impulsions and 
habits. Citing a few absurd impulsions : 
a person feels compelled to step over every 


crack, to touch the posts along his journey, 
to take the stairs three steps at a time. The 
habits range from the queer desire to bite 
one's nails to the quick that is so common 
in children and which persists in the psych- 
asthenic adult, to the odd grimaces and facial 
contortions, blinking eyes and cracking joints 
of the inveterate ticquer. Against some of 
these habit spasms, comparable to severe 
stammering, all measures are in vain, for 
there seems to be a queer pleasure in these 
acts against which the will of the patient is 

Especially do the first two described types 
of trouble follow exhaustion, acute illness, 
sudden fright, and long painful ordeal. The 
ground is prepared for these conditions, e.g. 
by the strain of long attendance on a sick 
husband or child. Then, suddenly one day, 
comes a queer fear or a faint dizzy feeling 
which awakens great alarm, is brooded upon, 
wondered at, and its return feared. This 
fearful expectation really makes the return 
inevitable, and then the disease starts. If 
the patient would seek competent advice 
at this stage, recovery would usually be 
prompt. Instead, there is a long unsuccessful 


struggle, with each defeat tending to make 
the fear or anxiety or obsession habitual. 
Sometimes, perhaps in most cases, and in all 
cases according to Freud and his followers, 
there is a long-hidden series of causes behind 
the symptoms ; subconscious sexual conflicts 
and repressions, etc. It may be stated here 
that the present author is not at all a Freudian 
and believes that the causes of these forms of 
nervousness are simpler, more related to the 
big obvious factors in life, than to the curi- 
ously complicated and bizarrely sexual Freu- 
dian factors. People get tired, disgusted, 
apprehensive; they hate where they should 
love; love where they should hate; are 
jealous unreasonably; are bored, tortured 
by monotony; have their hopes, purposes, 
and desires frustrated and blocked; fear 
death and old age, however brave a face 
they may wear ; want happiness and achieve- 
ment, and some break, one way or another, 
according to their emotional and intellectual 
resistance. These and other causes are the 
great factors of the conditions we have been 

Of all the forms of nervousness proper, the 
psychoneuroses, hysteria is probably the one 


having its source mainly in the character of 
the patient. That is to say, outward happen- 
ings play a part which is secondary to the per- 
sonality defect. Hysteria is one of the oldest 
of diseases and has probably played a very 
important role in the history of man. 
Unquestionably many of the religions have 
depended upon hysteria, for it is in this field 
that "miracle cures" occur. All founders 
of religions have based part of their claim on 
the belief of others in their healing power. 
Nothing is so spectacular as when the hys- 
terical blind see, the hysterical dumb talk, 
the hysterical cripple throws away his crutches 
and walks. In every age and in every 
country, in every faith, there have been the 
equivalents of Lourdes and St. Anne de 

In hysteria four important groups of symp- 
toms occur in the housewife as well as in her 
single sisters and brothers. 

There is first of all an emotional instability, 
with a tendency to prolonged and freakish 
manifestations, — the well-known hysterics 
with laughing, crying, etc. Fundamental in 
the personality of the hysterics is this in- 
stability, this emotionality, which is however 


secondary to an egotistic, easily wounded 
nature, craving sympathy and respect and 
often unable legitimately to earn them. 

A group of symptoms that seem hard to 
explain are the so-called paralyses. These 
paralyses may affect almost any part, may 
come in a moment and go as suddenly, or 
last for years. They may concern arm, leg, 
face, hands, feet, speech, etc. They seem 
very severe, but are due to worry, to mis- 
directed ideas and emotions and not at all 
to injury to the nervous system. They are 
manifestations of what the neurologists call 
"dissociations of the personality." That is, 
conflicts of emotions, ideas, and purposes of 
the type previously described have occurred, 
and a paralysis has resulted. These paralyses 
yield remarkably to any energizing influence 
like good fortune, the compelling personality 
of a physician or clergyman or healer (the 
miracle cure), or a serious danger. The 
latter is exemplified in the cases now and then 
reported of people who have not been out of 
bed for years, but are aroused by threat of 
some danger, like a fire, reach safety, and 
thereafter are well. 

Similar in type to the paralyses are losses 


of sensation in various parts of the body, — 
losses so complete that one may thrust a 
needle deep into the flesh without pain to 
the patient. In the days of witch-hunting 
the witch-hunters would test the women 
suspected with a pin, and if they found places 
where pain was not felt, considered they had 
proof of witchcraft or diabolic possession, so 
that many a hysteric was hanged or drowned. 
The history of man is full of psychopathic 
characters and happenings ; insane men have 
changed the course of human events by their 
ideas and delusions, and on the other hand 
society has continually mistaken the insane 
and the nervously afflicted for criminals or 
wretches deserving severest punishment. 

Especially striking in hysteria are the 
curious changes in consciousness that take 
place. These range from what seem to be 
fainting spells to long trances lasting perhaps 
for months, in which animation is apparently 
suspended and the body seems on the brink 
of death. In olden days the Delphian oracles 
were people who had the power voluntarily 
of throwing themselves into these hysteric 
states and their vague statements were taken 
to be heaven-inspired. To-day, their descend- 


ants in hysteria are the crystal gazers, the 
mediums, the automatic writers that by a 
mixture of hysteria and faking deceive the 
simple and credulous. 

For, in the last analysis, all hysterics are 
deceivers both of themselves and of others. 
Their symptoms, real enough at bottom, are 
theatrical and designed for effect. As I shall 
later show, they are weapons, used to gain an 
end, which is the whim or will of the patient. 

In order to clinch our understanding of the 
above conditions we must now consider in 
more detail certain phases of emotion. 

Fear curdles the blood, anger floods the 
body with passion, sorrow flexes the proud 
head to earth and stifles the heartbeat ; joy 
opens the floodgates of strength, and hope 
lifts up the head and braces man's soul. 

Man is said to be a rational being, but his 
thought is directed mainly against the prob- 
lems of nature, much more rarely against his 
own problems. It is for emotion that we 
live, for emotion in the wide sense of pleasure 
and pride. What guides us in our conduct 
is desire, and desire in the last analysis is 
based on the instincts and the allied emotions, 
— hunger, sex, property, competition, co- 


operation. The intelligence guides the in- 
stincts and governs the emotions, but in the 
case of the vast majority of mankind is swept 
out of the field when any great decision is to 
be made. 

We are accustomed to thinking of emotion 
as a thing purely psychical, — purely of the 
mind, despite the fact that all the great 
descriptions and all the homely sayings por- 
tray it as bodily. "My heart thumped 
like a steam engine," or "I could not catch 
my breath"; "a cold chill played up and 
down my back"; "I swallowed hard, be- 
cause my mouth was so dry I could not 
speak." And the Bible repeatedly says of 
the man stricken by fear, "His bowels turned 
to water," with a graphic force only equaled 
by its truth. 

William James, nearly simultaneously with 
Lange, pointed out that emotion cannot be 
separated from its physical concomitants and 
maintain its identity. That is, if we separate 
in our minds the weak, chilly feeling, the dry 
mouth, the racing heart, the sharp, harsh 
breathing, and the tension of the muscles 
getting ready for flight from the feeling of 
fear, nothing tangible is left. Similarly with 


sorrow or joy or anger. Take the latter 
emotion ; imagine yourself angry, — imme- 
diately the jaw becomes set and the lips 
draw back in a semi-snarl, the fists clench 
and the muscles tighten, while the head and 
body are thrust forward in what is, as Dar- 
win pointed out, the preparation for pouncing 
on the foe. Even if you mimic anger without 
any especial reason, there steals over you a 
feeling not unlike anger. 

In a famous paragraph James essentially 
states that instead of crying because we are 
sorry, it is fully as likely that we are sorry 
because we cry. So with every emotion ; we 
are afraid because we run away, and happy 
because we dance and shout. In other words 
he reversed the order of things as the every- 
day person would see it ; makes primary and 
of fundamental importance the physical re- 
sponse rather than the feeling itself. 

This has been widely disagreed with, and 
is not at all an acceptable theory in its 
entirety. Yet modern physiology has shown 
that emotion is largely a physical matter, 
largely a thing of blood vessels, heartbeat, 
lungs, glands, and digestive organs. This 
physical foundation of emotion is a very 


important matter in our study of the housewife 
as of every other living person. For it is es- 
pecially in the emotional disturbance that the 
origin of much of nervousness is to be found, 
and that on what may be called the physical 
basis of emotion. 

What can emotion produce that is patholog- 
ical, detrimental to well-being? We may 
start with the grossest, simplest manifes- 
tations. It may entirely upset digestion, as 
in the vomiting of disgust and excitement. 
Or, in lesser measure, it may completely 
destroy the appetite, as occurs when a 
disturbing emotion arises at mealtime. This 
is probably brought about by the checking 
of the gastric secretions. (Cannon's work; 
Pavlow's work.) 

It may check the secretion of milk in the 
nursing mother, or it may change the quality 
of the milk so that it almost poisons the 
infant. It may cause the bladder and bowels 
to be evacuated, or it may prevent their 

It may so change the supply of blood in the 
body as to leave the head without sufficient 
quantity and thus bring about a fainting 
spell ; i.e. may absolutely deprive the victim 


of consciousness. In lesser degree it causes 
the blush, a visible manifestation of emotion 
often very distressing. 

It may completely abolish sex power in the 
male, or it may bring about sex manifestations 
which the victim would almost rather die 
than show. 

It may completely deenergize so that neither 
interest, enthusiasm, or power remains. This is 
a familiar effect of sorrow but occurs in lesser 
degree with the form of fear called worry. 

The fact is that emotion is an intense bodily 
response to a situation which when perceived 
is the state of feeling. This intense bodily 
response, involving the very minutest tissues 
of the body, may increase the available 
energy, may help the bodily functioning, 
may stimulate the "psychical" processes, 
but also it may deenergize to an extraordinary 
degree, it may interfere with every function, 
including thought and action. It may surely 
produce acute illness, and it may, though 
rarely, produce death. 

Moreover, it is extraordinarily contagious. 
Every one knows how a hearty laugh spreads, 
and how quick the response to a smile. Indeed, 
emotion has probably for one of its main 


functions the producing of an effect on some 
one else, and all the world uses emotion for 
this purpose. Anger is used to produce fear, 
sorrow to evoke sympathy, fear is to bring 
about relenting, a smile and laughter, friend- 
liness, except where one smiles or laughs at 
some one, and then its design is to bring 
sorrow, anger, or pain. The leader maintains 
a hopeful, joyous demeanor so that his 
followers may also be joyous or hopeful and 
thus be energized to their best. Morale is 
the state of emotion of a group ; it is raised 
when joyous, energizing emotions are set 
working in the group and is lowered when 
pessimistic deenergizing emotions become 
dominant. A city or a nation becomes ener- 
gized with good news and success and de- 
energized when the battle seems lost. 

The spread of emotion from person to 
person by sympathetic feeling or the reverse 
(as when we get depressed because our enemy 
is happy) is a social fact of incalculable im- 
portance. The problem of the nervous house- 
wife is a problem of society because she gives 
her mood over to her family or else intensely 
dissatisfies its members so that the home 
ties are greatly weakened. 


This spread of emotion was happily por- 
trayed by a motion picture I recently saw. 
Old Grouchy Moneybags, wealthy beyond 
measure and afflicted with gout, is seated 
at his breakfast table. In the next room, 
seen with the all-seeing eye of the movie, 
the butler makes love to the very willing 
maid. In the kitchen the fat cook is feeding 
the ever hungry butcher's boy with ginger- 
bread and cake, and on the back steps the 
household cat is purring gently in content- 
ment. Happiness is the predominant note. 

Then Old Moneybags savagely rings the 
bell. Enters the butler, obsequious and solic- 
itous. "The coffee is bad, the toast is vile, 
everything is wrong. You are a deleted deleted 
deleted deleted rascal.' ' Exit the butler, out- 
wardly humble, inwardly a raging flood of 
anger, and he meets the maid, who archly 
invites his attentions. She gets them, only 
they are in the form of an angry shove and 
an oath. White with indignation, she stamps 
her foot and runs into the kitchen, bursting 
into tears. The cook, solicitous, receives a 
slap in the face, and as the maid bounces 
out, the cook, seeking a victim, grabs away 
the gingerbread from the butcher's boy. 


And that still hungry juvenile slams the 
door as he leaves and kicks the slumbering 
cat off the back doorstep. 

Unfortunately the film did not show what 
the outraged cat did. Possibly it started a 
devastation that reached back into Money- 
bags' career ; at any rate the unusual little 
picture (which later went on to the usual happy 
ending) showed how emotion spreads through 
the world, just as disease does. The infection 
that starts in the hovel finally strikes down 
the rich man's child, enthroned in the palace. 
The mood engendered by the humiliation of 
poverty or cruelty or any injustice finally 
shakes a king off his throne. 

So when we trace the deenergizing emo- 
tions of the housewife, we are tracing factors 
that affect her husband, his work, and Society 
at large; we trace the things that mold her 
children, and thus we follow her mood, her 
emotion, into the future, into history. 


Types of Housewife Predisposed to 

There are three main factors in the pro- 
duction of the nervousness of the housewife, 
and they weave and interweave in a very 
complex way to produce a variety of results. 
All the things of life, no matter how simple in 
appearance, are a complex combination of 
action and reaction. Our housewife's symp- 
toms are no exception, whether they are 
mainly pains, aches, and fatigue, or the 
deeply motivated doubt or feeling of un- 

The nature of the housewife, the conditions 
of her life, and her relations to her husband are 
these three factors. All enter into each case, 
though in some only one may be emphasized 
as of importance. There are cases where 
the nature of the woman is mainly the essen- 
tial cause, others where it is the conditions 


of her life, and still others where the husband 
stands out as the source of her symptoms. 

We are now to consider the nature of the 
housewife as our first factor. We may pre- 
amble this by saying that a woman essentially 
normal in one relationship in life may be 
abnormal in some other, may be the tradi- 
tional square peg in the round hole. More- 
over, we are to insist on the essential and 
increasing individuality of women, which 
is to a large extent a recent phenomenon. 
The cynical commonplace is "All women are 
alike" — and then follows the specific accu- 
sation — "in fickleness", " in extravagance", 
"in unreasonableness", in this trick or that. 
The chief effort of conservatism is to make 
them alike, to fit each one for the same life 
by the same training in habits, knowledge, 
abilities, and ideals. 

Talk about Prussianism ! The great 
Prussianism, with its ideal of uniformity, 
serviceability, and servility, has been the 
masculine ideal of woman's life. Man was 
to be diversified as life itself, was to taste 
all its experiences, but woman had her sphere, 
which belied all mathematics by being a 
narrow groove. 


The nineteenth century changed all that, — 
or started the change which is going on 
with extraordinary rapidity in the twentieth. 
There are all kinds of women, at least poten- 
tially. It may be true that woman tends 
less to vary than man, that she follows a 
conservative middle-of-the-road biologically, 
while man spreads out, but no one can be 
sure of this until woman's early training to 
some extent resembles man's. 

1. From the very start woman is trained 
to vanity. Every mother loves to doll up 
her girl baby, and the child is admired for her 
dress and appearance. Now it is an essential 
quality of the normal human being that he 
accepts as an ideal the quality most admired. 
To the young child, the girl, the young woman, 
the important thing is Looks, Looks, Looks ! 
The first question asked about a woman is, 
"Is she pretty?" The pretty girls, the ones 
most courted, the ones surest on the whole to 
get married and to become housewives are 
usually spoiled by indulgence, petting, admira- 
tion, and this for a quality not at all related 
to strong character, and therefore vanity 
of a trivial kind results. 

2. Moreover, woman is trained to 


emotionality. It may be that she is by 
nature more emotional than man, but again 
this can only be known when she has been 
trained to repress emotional response as a 
man is trained. If a boy cries or shows fear, 
he is scolded, and training of one kind or 
another is instituted to bring about moral 
and mental hardihood. But if a girl cries, 
she is consoled by some means and taught 
that tears are potent weapons, a fact she 
uses with extraordinary effect later on, espe- 
cially in dealing with men. If she shows 
fear, she is protected, sheltered, and given a 
sort of indulged inferiority. 

3. The romantic ideal is constantly held 
before her in the private counsel of her 
mother, in the books she reads, in the plays 
she witnesses, in all the allurements of art. 
She is to await the lover, the hero; he will 
take her off with him to dwell in love and 
happiness forever. All stories, or most of 
them, end before the heroine develops the 
neurosis of the housewife. In fact, literature 
is the worst possible preparation for married 
life, excepting perhaps the courtship. This 
latter emphasizes a distorted chivalry that 
makes of woman a petty thing on a pedestal, 


out of touch with reality; it is an exciting 
entrance into what in the majority of cases 
is a rather monotonous existence. 

All these things — vanity, emotionality, 
romanticism, courtship — are poor training 
for the home. They hinder even the strong- 
est woman, they are fetters for the more 

In taking up the special types predisposed 
to the nervousness of the housewife it is to be 
emphasized that conditions may bring about 
the neurosis in the normal housewife. 
Nevertheless, there are groups of women 
who, because of their make-up or constitution, 
acquire the neurosis much more easily and 
much more intensely than do the normal 
women. They are the types most commonly 
seen in the hospital clinic or in the private 
consulting room of the neurologist. 

First comes the hypersesthetic type. One 
of the chief marks of advancing civilization 
is an increasing refinement of taste and 
desire. The fundamental human needs are 
food, shelter, clothes, sex relations, and 
companionship. These the savage has as 
well as his civilized brother, and he finds 
them not only necessary but agreeable. What 


we call progress improves the food and the 
shelter, modifies the clothes, elaborates the 
sex relations and the code governing com- 
panionship. With each step forward the 
cruder methods become more actively dis- 
agreeable, and only the refined methods 
prove agreeable. In other words, desire keeps 
pace with improvement, so that although 
great advances materially have been made, 
there has been little advance, if any, in 
contentment. This is because as we progress 
in refinement little things come to be im- 
portant, manner becomes more essential than 
matter, and we get to the hyperasthetic 

Thus the dinner becomes less important 
than the manner of serving it. In the 
"highest circles" it is the savoir faire, the 
niceties of conduct, that count more than 
character. Words become the means of play- 
ing with thought rather than the means of 
expressing it, and thought itself scorns the 
elemental and fundamental and busies itself 
with the vagaries of existence. 

From another angle, to the hypersesthetic 
more and more things have become disagree- 
able. To the man of simple tastes and simple 





feelings, only the calamities are disagreeable; 
to the hypersesthetic every breeze has a 
sting, and life is full of pin pricks. "The 
slings and arrows of outrageous fortune" 
are multiplied in number, and furthermore 
the reaction to them is intensified. In the 
"Arabian Nights" the princess boasts that a 
rose petal bruises her skin, while her com- 
petitor in delicacy is made ill by a fiber of 
cotton in her silken garments. So with the 
hypersesthetic ; an unintentional overlooking 
is reacted to as a deadly insult ; the thwarting 
of any desire robs life of its savor; sounds 
become noises; a bit of litter, dirt; a little 
reality, intolerable crudity. 

A woman with this temperament is a poor 
candidate for matrimony unless there goes 
with it a capacity for adjustment, unusual in 
this type. Most men have their habitual 
crudities, their daily lapses, and every home 
is the theater of a constant struggle with the 
disagreeable. Intensely pleased by the ut- 
most refinements, these are too uncommon to 
make up for the shortcomings. The hyper- 
sesthetic woman is constantly the prey of 
the most deenergizing of emotions, — disgust. 
"It makes me sick" is not an exaggerated 


expression of her feeling. And her afflicted 
household size up the situation with the 
brief analysis, "Everything makes her nerv- 
ous." Every one in her household falls 
under the tyranny of her disposition, mingling 
their concern with exasperation, their pity 
with a silent almost subconscious contempt. 

Next comes the over-conscientious type. 
Whatever conscience is, whether implanted 
by God, or the social code sanctified by 
training, teaching, and a social nature, there 
can be no question that, as the Court of 
Appeals, it does harm as well as good. 

There are people whose lack of conscience 
is back of all manner of crimes, from murder 
down to careless, slack work ; whose cruelty, 
lust, and selfishness operate unhampered by 
restraint. On the other hand there are 
others whose hypertrophied conscience works 
in one of two directions. If they are zealots, 
convinced of the righteousness of their own 
decisions and conclusions, their conscience 
spurs them on to reforming the world. Since 
they are more often wrong than right, they 
become, as it were, a sort of misdirected 
Providence, raising havoc with the happiness 
and comfort of others. WTiether the con- 


scienceless or those overburdened with this 
type of conscience have done more harm in 
the world is perhaps an open question, which 
I leave to the historians for settlement. 

The other type of the overconscientious 
does definite harm to themselves. This type 
I have called the "Seekers of Perfection" 
and it is their affliction that they are miser- 
able with anything less. They are partic- 
ularly hard on themselves, differing in this 
wise from the hyper aesthetic. Constantly 
they examine and reexamine what they have 
done. "Is it the best I can do?" "Should 
I rest now; have I the right to rest?" 

Into every moment of enjoyment they 
obtrude conscience, or rather conscience ob- 
trudes itself. They become wedded to a 
purpose, and then that purpose becomes a 
tyrant allowing no escape, even for a brief 
pleasure, from its chains. Nothing is right 
that wastes any time ; nothing is good but the 
best. The sense of humor is conspicuously 
lacking in this type, for one of the main 
functions of humor is to season effort and 
straining purpose with proportion. 

Should one of these unfortunates be a 
housewife, then she is continually "picking 


up", continually pursuing that household 
Will-o'-the-Wisp, "finishing the work." For 
it is the nature of housework that it is never 
finished, no matter how much is done. This 
overconscientious person, unless she is made 
of steel springs and resilient rubber, breath- 
lessly chasing this phantom all day and into 
the night, gives way under the strain, even 
though she have a dozen servants to help. 
For to this type each helper is not at all an 
aid. At once up goes the standard of what 
is to be done, and each servant becomes an 
added care, an added responsibility. 

"I 'd love to go out with you," wails this 
housewife, "but there 's something I must 
finish to-day." The word must, self-imposed, 
becomes the mania of her life, to the open 
rebellion of her household. The word drives 
her to the real neglect of her husband, who 
becomes irritated at her constant and to him 
needless activity, coupled with her com- 

"Why don't you rest if you are tired," is 
his stock remonstrance; "the house looks 
all right to me." 

But it is futile. She becomes irritated, 
perhaps cries and says, "Just like a man. 


It 's clean to you if there are no cobwebs on 
the walls." 

Whereupon the debate closes, but the 
woman is the more deenergized and the man 
exasperated at the unreasonableness of women 
in general and his wife in particular. 

It is probably true that woman has more 
conscience, in so far as detail is concerned, 
than man. She is more of a lover of order and 
neatness, more wedded to decorum. Man 
loves comfort and his interest is more spe- 
cialized and analytical, and as a rule he 
hates fussiness. 

This hatred of fussiness makes him long 
for the masculine clubroom, gives him the 
kind of uneasiness that sends him off on a 
fishing trip or hunting expedition. Further, 
and this is of great social importance, many 
a broken home, many an unexplainable 
triangle of the Wife, the Husband, and the 
Other Woman owes its existence, not to the 
charms of the other woman, but to the over- 
conscientious wife. 

The third type predisposed to the neurosis 
of the housewife is the overemotional woman. 

We have already considered the effect of 
certain types of emotion on health and en- 


durance and may formulate it as follows: 
Emotion may act as a great bodily disturb- 
ance, affecting every organ and every function 
of the body. What we call nervousness is 
largely made up of abnormal emotional re- 
sponse, of persistent emotion, of the blocking 
of energy by emotion. 

Now people differ from the very start of 
life in their response to situations. One 
baby, if he does not get what he wants, turns 
his attention to something else, and another 
will cry for hours or until he gets it. One 
will manifest anger and strike at being 
blocked or impeded in his desires, and the 
other will implore and plead in a baby way 
for his wish. 

In the face of difficulties one man shows 
fear and worry, another acts hastily and 
without premeditation, a third flares up in 
what we call a fighting spirit and seeks to 
batter down the resistance, and still a fourth 
becomes very active mentally, calling upon 
all of his past experience and seeking a 
definite plan to gain his end. 

A loss, a deprivation, plunges one type of 
person into deepest sorrow, a helpless sorrow, 
inert and symbolic of the hopeless frustration 


of love. The same affliction striking at 
another man's heart makes him deeply and 
soberly reflective, and out of it there ensues a 
great philanthropy, a great memorial to his 
grief. For the one, sorrow has deenergized; 
for the other it has energized, has raised the 
efforts to a nobler plane. 

Now there are women, and also men, to 
whom emotion acts like an overdose of a 
drug. Parenthetically, emotion and certain 
drugs have very similar effects. No matter 
how joyous the occasion and how exuberant 
their joy, a mood may settle into their lives 
like a fog and obscure everything. This 
mood may arise from the smallest disappoint- 
ment ; or a sudden vision of possible disaster 
to one they love may appear before them 
through some stray mental association. They 
are at the mercy of every sad memory and of 
every look into the future. 

Preeminently, they are the victims of that 
form of chronic fear called worry, more 
aptly named by Fletcher "fearthought." He 
implied by this name that it was a sort of 
degenerated "forethought." 

If the baby has a cough, then it may have 
tuberculosis or pneumonia or some disastrous 


illness, of which death is the commonest 
ending. How often is the doctor called in 
by these women and needlessly, and how she 
does keep his telephone busy ! It is true 
that a cough may be early tuberculosis, but 
this is the last possibility rather than the 

If the husband is late, Heaven knows what 
may have happened. She has visions of him 
lying dead in some morgue, picked up by the 
police, or he 's in a hospital terribly injured 
by an automobile, or, perchance, a robber 
has sandbagged him and dragged him into a 
dark alley. If she is a bit jealous, and he is 
at all attractive, then the disaster lies that 
way. It does n't matter that his work may 
be such that he cannot be at home regularly 
or on schedule ; the sinister explanation takes 
possession of her to the exclusion of the more 
rational; she has a sort of affinity for the 
terrible. And when her husband comes home, 
the profound fear in many cases turns sharply 
and quickly to anger at him. Her distorted 
sense of responsibility makes him the culprit 
for her unnecessary fear. 

Now it is true that almost every woman 
has something of this tendency, but it is only 


the extreme case that I am here depicting. 
In this extreme form, this type of woman is 
commonly found among the Jews. The Jew- 
ish home reverberates with emotionality and 
largely through this attitude of the Jewish 

Such a woman is apt to make a slave of her 
family through their fear of arousing her 
emotions. How frequently people are chained 
by their sympathies, how frequently they are 
impeded in enjoyment by the tyranny of 
some one else's weakness, would fill one of 
the biggest chapters in a true history of the 
human race, — a book that will probably 
never be written. 

Naturally enough, this housewife finds 
plenty to worry about, to react to, and since 
these reactions are physical, they have a 
lowering effect on her energy. 

To those familiar with the conception that 
every emotion, every feeling, needs a dis- 
charge, it will seem heretical when I say 
that the excessive discharge of emotion is 
harmful. Freud finds the root of most nerv- 
ous trouble in repressed emotion. That is 
in part true, but it is also true that excessive 
emotionality is a high-grade injury, for emo- 


tional discharge is habit forming. It becomes 
habitual to cry too much, to act too angry, 
to fear too much. The conquest and dis- 
ciplining of emotion is one of the great objects 
of training. It has for its goal the supremacy 
of the noblest organ of the human being, his 
brain. For proper living there must be 
emotion — there always will be — but it 
must be tempered with intelligence if the 
best good of the individual and the race 
is to be reached. 

The type of woman we must now study is a 
very modern product, the non-domestic type. 

That the great majority of women have a 
maternal instinct does not nullify the fact 
that a small number have none whatever. 
One of the facts of life, not taken into account 
with a fraction of its true significance and 
importance, is the variability of the race, 
the wide range of abilities, instincts, emotions, 
aspirations, and tastes. A quality is said to be 
normal when the majority of the group possess 
it, but it may be utterly lacking in a smaller 
number who are thereby declared abnormal. 

At present, it is normal for woman to be 
domestic, i.e. to yearn for husband, home, and 
children ; to want to be a housewife. Un- 


fortunately, all these ^earnings do not hang 
closely together, and a woman may want a 
husband and be swept by her own desire and 
opportunity into matrimony, and yet she 
may "detest" children, may dislike the house- 
keeping activities of marriage. The sex and 
other instincts upon which marriage is based 
are not always linked with the maternal and 
home-keeping instincts. 

While this has probably always been true, 
it mattered little in olden days. A woman 
regarded the'home as her destiny and generally 
had experienced no other life. But as was 
shown in the first chapter, industry and 
feminism have given woman a taste of other 
kinds of life and have developed her individual 
points of character and abilities. Perhaps 
she has been the bookkeeper of a large 
concern ; or the private secretary to a man of 
exciting affairs; or she has been the buyer 
for some house ; or she has dabbled in art or 
literature; or she has been a factory girl 
mingling with hundreds of others, working 
hard, but in a large group ; or a saleslady in a 
department store, — and domestic life is ex- 
pected of her as if she had been trained for it. 
In fact, she has been trained away from it. 


The novelists delight to tell us of the woman 
who seeks a career and enters the struggle of 
her profession and fails. And then there 
comes, just when her failure is greatest and 
she is most weepingly feminine, the patient 
hero, and he holds out his arms, and she slips 
into them, oh, so joyously ! She now has a 
home, and will be happy — long row of 
asterisks, and have children; and if it is a 
movie, a year or more elapses and we are 
permitted to gaze upon a charming domestic 

But alas for reel life as against real life ! 
We are not shown how she yearns for the 
activities of her old career; we are not 
shown the feeling she constantly has that she 
is too good for housekeeping. If she has 
been fortunate enough to marry a rich and 
indulgent man, she becomes a dilettante in 
her work, playing with art or science. If her 
first vocation was business, she is bored to 
death by domesticity. But if she marries 
poverty, she looks on herself as a drudge, and 
though loyalty and pride may keep her from 
voicing her regrets, they eat like a canker 
worm in the bud, — and we have the neurosis 
of this type of housewife. Or else her 


experience in business makes her size up her 
husband more keenly, and we find her re- 
belling against his failure, criticizing him 
either openly to the point of domestic dis- 
harmony, or inwardly to her own disgust. 

It is not meant that all business and pro- 
fessional women, all typists and factory 
girls are dissatisfied with marriage or develop 
an abnormal amount of neurosis. Many a 
girl of this type really loves housekeeping, 
really loves children, and makes the ideal 
housewife. Intelligent, clear-eyed, she man- 
ages her home like a business. But if in- 
dependent experience and a non-domestic 
nature happen to reside in the same woman, 
then the neurosis appears in full bloom. 
Against the adulation given to women singers 
and actresses, against the fancied rewards 
of literature and business, the domestic lot 
seems drab to this non-domestic type. 

Here the question arises : Is there room in 
our society for matrimony and a business 
career? That a large number of exceptional 
women have found it possible to be mothers, 
housewives, authors, and singers at one and 
the same time does not take away from the 
fact that in the majority of cases such a 


combination means either a childless mar- 
riage or the turning over of an occasional 
child to servants : it means the abandon- 
ment of the home and the living in hotels, 
except in the few cases where there is wealth 
and trusty servants. Wherever women who 
have children are poor and work in factories, 
there is the greatest infant mortality, there is 
the greatest amount of juvenile delinquency, 
and there is the greatest amount of marital 
difficulty. Our present conception of matri- 
mony demands that woman remains in the 
home until such time at least as her children 
are able to care largely for themselves. 

In the history of the worst cases of the 
housewife's neurosis one finds previously exist- 
ing trouble, though, as I have before this 
emphasized, the neurosis may develop in the 
previously normal. This previously existing 
trouble is the "nervous breakdown" in high 
school or in college, or in the factory and the 
office, though it must be said it occurs 
relatively less often in the latter places than 
the former. This previous breakdown often 
appears as the direct result from emotional 
strain such as an unhappy love affair, or the 
fear of failure in examinations. It may have 


followed acute illness, like influenza or pneu- 
monia. But the original temperament was 
nervous, high-strung, delicate; one learns 
of an appetite that disappeared easily, a sleep 
readily disturbed, in short, an easily lowered 
or obstructed output of energy. 

This type of woman, neurotic from her 
very birth, is often the very best prod- 
uct of our civilization from the stand- 
point of character and ability, just as the 
male neurasthenic is often the backbone of 
progress and advancement. But we are con- 
cerned with these questions : "What happens 
to her in marriage ? " " How about her fitness 
for marriage? " 

As to the first question, we may say that 
all depends on whom and how she marries. 
For after all a woman does not marry matri- 
mony, she marries a man, a home, and generally 
children. And if the neurotic woman marries 
a devoted, kindly, conscientious man with 
wealth enough to give her servants in the 
household and variety in her experiences, 
she is as reasonably well off as could be 
expected. She is no worse off than if she 
had remained single and continued to be a 
school teacher, social worker, typist, factory 


hand the rest of her days, — and she has 
fulfilled more of her desires and functions. 
But if she marries an unsympathetic, im- 
patient man or a poor one, or a combination, 
then the first child brings a breakdown that 
persists, with now and then short periods of 
betterment, for many years. Then we have 
the chronic invalid, the despair of a household, 
the puzzle of the doctors. "Not really sick," 
say the latter to the discouraged husband, 
seeking to adjust himself to his wife, "only 
neurasthenic. All the organs are O. K." 
To differentiate between a lowered energy 
and imaginary illness or laziness is a hard 
task to which this husband is usually un- 
equal. Though some show of duty and kind- 
ness remains, love dies in such a household. 
And the very effort to give sympathy where 
doubt exists as to the genuineness of the 
affliction is painful and increases the chasm 
between wife and husband. 

That some of the sweetest marriages result 
where the wife is of this type does not change 
the general situation that such a marriage 
is an increased risk. Should a man know- 
ingly marry such a woman ? The question is 
futile in the overwhelming majority of cases. 


He will marry her, is the answer. For the 
fascinating woman is frequently of this type. 
Witness the charm of the neuropathic eye 
with its widely dilated pupil that changes 
with each emotion, the mobile face, — deli- 
cate, with a play of color, red and white, that 
is charming to look at, but which the grim 
physician calls "Vasomotor instability.' * 
There is nothing neutral about this type ; she 
is either very lovely or a freak. 

So all advice in the matter is of little avail. 
And racially speaking it is good that it is of 
no avail. I believe firmly that such a woman 
is more often the mother of high ability than 
her more placid sister ; that something of the 
delicacy of feeling and intensity of reaction 
of neurasthenia is a condition of genius. 
We are too far away from any real knowledge 
of heredity to advise for or against marriage 
in the most of cases on this basis, and cer- 
tainly we must not repeat Lombroso and 
Nordau's errors and call all variations from 
stupidity degeneration. 

But this does not change the domestic 
situation of the man who is usually much 
more concerned with his own comfort than 
the mathematical possibilities of his off- 


spring being geniuses. Certainly such a 
woman as the type now considered is not a 
poor man's wife, for she really needs what 
only the rich can have, — servants, variety, 
frequent vacations, and freedom from worry. 
Now worry cannot be shut out of even the 
richest home, for illness, old age, and death 
are grim visitors who ask no man's leave. 
But poverty and its worries are kept away by 
wealth, and poverty is perhaps the most 
persistent tormentor of man. 

Essential in the study of "nervousness" is 
the physical examination, and we here pass to 
the physically ill housewife. 

It is important to remember that the 
diagnosis of neurasthenia is, properly speak- 
ing, what is called by physicians a diagnosis 
of exclusion. That is to say, after one has 
excluded all possible illnesses that give rise to 
symptoms like neurasthenia, then and then 
only is the diagnosis justified. That is, a 
woman physically ill, with heart, lung, or 
kidney disease, or with derangements of the 
sexual organs, may act precisely like a nervous 
housewife, — may have pains and aches, 
changes in mood, loss of control of emotion ; 
in a word may be deenergized. 


It is not often enough remembered that 
bearing children, though a natural process, 
is hazardous, not only in its immediate 
dangers but to the future health of the 
woman. Injuries to the internal and external 
parts occur with almost every first birth, 
especially if that birth occurs after twenty- 
five years of age. Repair of the parts imme- 
diately is indicated, but in what percentage 
of cases is this done? In a very small 
percentage of cases, I venture to state, not 
only in my own small experience in this work, 
but on the statements of men of large expe- 
rience and high authority. 

In this connection I may state that the 
leading obstetricians believe that the woman 
of to-day has a harder time in labor than 
her predecessors. Aside from the more or 
less mythical stories of the savage women who 
deliver themselves on the march, there seems 
to be no reasonable doubt that in an increas- 
ing civilization and feminization, woman 
becomes less able to deliver herself, espe- 
cially at the first birth. 

Why is this? After all, it is a funda- 
mental matter. And moreover it is more 
often the tennis-playing, horseback-riding, 


athletic girl who falls short in this respect 
than the soft-limbed, shrinking, old-fashioned 
girl. Does a strenuous existence make against 
easy motherhood ? It would seem so ; it 
would seem the more masculine the occu- 
pations of woman become, the less able are 
they to carry out the truly female functions. 
But this is a digression from our point. 

A retroverted uterus, a lacerated perineum, 
such minor difficulties as flat feet, such major 
ones as valvular disease of the heart, are 
causes of ill health to be ruled out before 
"nervousness" (or its medical equivalents) 
is to be diagnosed. 

It is superfluous to say that we have here 
briefly considered only a few of the types 
specially predisposed to difficulty. More- 
over men and women do not readily fall 
into "types." A woman may be hyper- 
aesthetic in one sphere of her tastes and as 
thick-skinned as a rhinoceros in others. She 
may squirm with horror if her husband snores 
in his sleep, but be willing to live in an ugly 
modern apartment house with a poodle dog 
for her chief associate. Or the overcon- 
scientious woman may expend her energies 
in chasing the last bit of dirt out of her house 


but be willing to poison her family with three 
delicatessen meals a day. The overemotional 
housewife may flood the household with her 
tears over trifles but be a very Spartan in the 
grave emergencies of life. And the neurotic 
woman, a chronic invalid for housework, 
may do a dragoon's work for Woman Suffrage. 
It may be that no man can understand 
women; it is a fact they do not understand 
themselves. But in this they are not unlike 

One might speak of the jealous woman, 
the selfish woman, the woman envious of her 
more fortunate sisters, poisoning herself by 
bitter thoughts. These traits belong to all 
men and women; they are part of human 
nature, and they have their great uses as 
well as their difficulties. Jealousy, selfish- 
ness, envy, three of the cardinal sins of the 
theologian, are likewise three of the great 
motive forces of mankind. They are im- 
portant as reactions against life, not as 
qualities, and we shall so consider them in 
a later chapter. 

Though we have discussed the types pre- 
disposed to the nervousness of the house- 
wife, it is a cardinal thesis of this book 


that great forces of society and the nature 
of her life situation are mainly responsible. 
From now on we are face to face with 
these factors and must consider them frankly 
and fully. 


The Housework and the Home as Factors 
in the Neurosis 

One of the most remarkable of the traits 
of man is the restless advancement of desire, 
— and consequently the never-ending search 
for contentment. What we look upon as a 
goal is never more than a rung in the ladder, 
and pressure of one kind or another always 
forces us on to further weary climbing. 

This is based on a great psychological law. 
If you put your hand in warm water it feels 
warm only for a short time, and you must 
add still warmer water to renew the stimulus. 
Or else you must withdraw your hand. The 
law, which is called the Weber-Fechner Law, 
applies to all of our desires as well as to our 
sensations. To appreciate a thing you must 
lose it ; to reach a desire's gratification is to 
build up new desires. 

This is to be emphasized in the case of the 


housewife, but with this additional factor : 
that how one reacts to being a housewife 
depends on what one expects out of life and 
housekeeping. If one expects little out of 
life, aside from being a housewife, then there 
is contentment. If one expects much, de- 
mands much, then the housewife's lot leads 
to discontent. 

What is disagreeable is not a fixed thing, 
except for pain, hunger, thirst, and death. 
The disagreeable is the balked desire, the 
obstructed wish, the offended taste. It is a 
main thesis of this book that the neurosis 
of the housewife has a large part of its origin 
in the increasing desires of women, in their 
demands for a fuller, more varied life than 
that afforded by the lot of the housewife. 
Dissatisfaction, discontent, disgust, discour- 
agement, hidden or open, are part of the 
factors of the disease. Furthermore there is 
an increasing sensitiveness of woman to the 
disagreeable phases of housework. 

What are these phases that are attended with 
difficulty ? 1. The status of the house work. 

It is an essential phase of housework that 
as soon as woman can afford it she turns it 
over to a servant. Furthermore there is 


greater and greater difficulty in getting serv- 
ants, which merely means that even the 
so-called servant class dislikes the work. 
No amount of argument therefore leads away 
from the conclusion that housework must be 
essentially disagreeable, in its completeness. 
There may be phases of it that are agree- 
able ; some may like the cooking or the 
sewing, but no one likes these things plus 
the everlasting picking up ; no one likes 
the dusting, the dishwashing, the clothes 
washing and ironing, the work that is no 
sooner finished than it beckons with tyran- 
nical finger to be begun. To say nothing of 
the care of the children ! 

I do not class as a housewife the woman 
who has a cook, two maids, a butler, and a 
chauffeur, — the woman who merely acts 
as a sort of manager for the home. I mean 
the poor woman who has to do all her own 
work, or nearly all ; I mean her somewhat 
more fortunate sister who has a maid with 
whom she wrestles to do her share, — who 
relieves her somewhat but not sufficiently 
to remove the major part of housewifery. 
After all, only one woman in ten has any 
help at all ! 


It is therefore no exaggeration when I 
say that though the housewife may be the 
loveliest and .most dignified of women, her 
work is to a large extent menial. One may 
arise in indignation at this and speak of the 
science of housekeeping, of cleanliness, of 
calories in diet, of child-culture; one may 
strike a lofty attitude and speak of the Home 
(capital H), and how it is the corner stone of 
Society. I can but agree, but I must remind 
the indignant ones that ditch diggers, gar- 
bage collectors, sewer cleaners are the back- 
bone of sanitation and civilization, and yet 
their occupations are disagreeable. 

"Fine words butter no parsnips." There 
are some rare souls who lend to the humblest 
tasks the dignity of their natures, but the 
average person frets and fumes under similar 
circumstances. In its aims and purposes 
housekeeping is the highest of professions; 
in its methods and technique it ranks amongst 
the lowest of occupations. We must separate 
results, ideals, aims, and possibilities from 

All work at home has the difficulty of the 
segregation, the isolation of the home. Man, 
the social animal who needs at least some one 


to quarrel with, has deliberately isolated his 
household, somewhat as a squirrel hides 
nuts, — on a property basis. There has 
grown up a definite, aesthetic need of privacy ; 
all of modesty and the essential family feeling 
demand it. 

This is good for the man, and perhaps for 
the children, but not for the woman. Her 
work is done alone, and at the time her 
husband comes home and wants to stay 
there, she would like to get out. Work that 
is in the main lonely, and work that on the 
whole leaves the mind free, leads almost 
inevitably to daydreaming and introspection. 
These are essentials, in the housework, — 
monotony, daydreaming, and introspection. 

Let us consider monotony and its effects. 
The need of new stimuli is a paramount need 
of the human being. Solitary confinement 
is the worst punishment, so cruel that it is 
prohibited in some communities. We need 
the cheerful noises of the world, we need as 
releasers of our energies the sights, sounds, 
smells of the earth ; we must have the voices 
and the presence of our fellows, not for edu- 
cation, but for the maintenance of interest 
in living. For the mind to turn inward on 


itself is pleasurable only in rare snatches, 
for short periods of time or for rare and 
abnormal people. Man's mind loves the 
outside world but becomes uneasy when 
confronted by itself. 

The human being, whether male or female, 
housewife or industrial worker, is a seeker 
of sensations. Without new sensations man 
falls into boredom or a restless and unhappy 
state, from which the mind seeks freedom. It 
is true that one may become a mere seeker of 
sensations, a restless and fickle pleasure lover 
who passes from the normal to the abnormal, 
exotic in his vain search for what is logically 
impossible, — lasting novelty. Variety how- 
ever is not the mere spice of life; it is the 
basis of interest and concentrated purpose as 

People of course vary greatly in what they 
regard as variety, and this is often a con- 
stitutional matter as well as a matter of 
education. What is new, striking and 
interest-provoking to the child has not the 
same value to the adult; what is boredom 
to the city man might be of huge interest 
to the country man. A person trained to 
a certain type of life, taught to expect cer- 


tain things, may find no need of other newer 
things. In other words people accustomed 
to a wide range of stimuli need a wide range, 
while people unaccustomed to such a range do 
not need it. 

The most important stimuli are other 
persons, capable of setting into action new 
thoughts, new emotions, new conduct. We 
need what Graham Wallas calls "face to 
face associations of ideas", — ideas called 
into being by words, moods, and deeds of 

It is this group of stimuli that the busy 
housewife conspicuously lacks. "She has no 
one to talk to," especially in the modern 
apartment life. It is true she has her chil- 
dren to scold, to discipline, to te.ach, and to 
talk at; but contact with child minds is 
not satisfying, has not the flavor of 
companionship, is not reciprocal in the sense 
that adult minds are. There therefore results 
introspection and daydreaming, both of which 
may be of slight importance to some women 
but which are distinctly disastrous to others. 

If the married life is satisfactory the day- 
dreaming and introspection may be very 
pleasurable, as they usually are at the 


beginning of marriage. The young bride 
dreams of love that does not swerve, of 
understanding that persists, of success, of 
riches to come, of children that are lovely 
and marvelous. And the happy woman 
also finds her thoughts pleasant ones, and 
her castles in the air are mere enlargements 
of her life. 

But the dissatisfied woman, the unhappy 
woman, finds her daydreams pleasant and 
unpleasant at the same time, She is con- 
stantly coming back to reality; reality con- 
stantly obtrudes itself into her dreams. The 
daydreaming is rebelled against as foolish, 
as puerile, as futile. A struggle takes place 
in the mind ; disloyal and disastrous thoughts 
creep in which are constantly dismissed but 
always reappear. The profoundest disgust 
and deenergization may appear, and fatigue, 
aches, pains, and weariness of life often results. 

One may compare interest to a tonic. 
How often does one see a little group, who 
for the time being are not interesting to one 
another, sit sleepy, tired, bored, yawning, 
restless. Then a new person enters, a person 
of importance or of interest. The fatigue 
disappears like magic, and all are bright, 


energetic, sparkling. The basis of club life 
is the monotony of the home; man uses the 
saloon, the clubroom, the pool room, the 
street corner, the lodge meeting, as an escape 
from the unstimulating atmosphere of wife 
and family, — the hearth. But for the 
housewife there is usually no escape, though 
she needs it more than her husband does. 

Furthermore the non-domestic type, the 
woman with especial ability, the woman 
who has been courted, petted, and sought for 
before marriage is the one who reacts most to 
the monotony of the home. There are plenty 
of women who consider the home a refuge 
from a world they find more strenuous, more 
fatiguing than they can stand, or who find 
in housework a consecration to their ordained 
duty. Which type is the better woman 
depends upon the point of view, but it is safe 
to say that feminism and the industrial 
world are making it harder and harder for 
an increasing number of women to settle 
down to home-keeping. 

The housewife is far excellence a sedentary 
creature. She goes to work when she gets 
up in the morning, within doors. She goes 
to bed at night, very frequently without 


having stirred from the home. A great 
many women, especially those who have no 
help and have children, find it next to im- 
possible to get out of doors except for such 
incidental matters as hanging out the clothes 
or going to the grocery. 

It is true that some women so situated 
get out each day. But they are possessed 
either of greater energy or skill or else own a 
less urgent conscience. At least for many 
women it gets to be a habit to stay in. If 
there is a moment of leisure, a chair or a 
couch, and a book or paper, seem the logical 
way of resting up. 

Now sedentary life has several main effects 
upon health and mood. It tends quite defi- 
nitely to lower the vigor of the entire or- 
ganism. Perhaps it is the poor ventilation, 
perhaps it is the lack of the exercise necessary 
for good muscle tone that brings about this 
result. Though the housewife may work hard 
her muscles need the tone of walking, run- 
ning, swimming, lifting, that our life for 
untold centuries before civilization made 
necessary and pleasurable. 

With this sedentary life comes loss of 
appetite or capricious appetite. Frequently 


the housewife becomes a nibbler of food, she 
eats a bite every now and then and never 
develops a real appetite. Nor is this a female 
reaction to "food close-at-hand " ; watch 
any male cook, or better still take note of the 
man of the house on a Sunday. He spends a 
good part of his day making raids on the ice 
chest, and it is a frequent enough result 
to find him "logy" on Monday. 

Furthermore, in the household without a 
servant, the housewife rarely eats her meal 
in peace and comfort. She jumps up and 
down from each course, and immediately 
after the meal she rarely relaxes or rests. 
The dishes must be cleared away and washed, 
and this keeps from her that peace of mind so 
necessary for good digestion. 

An increasing refinement of taste adds to 
these difficulties. If the family eat in the 
dining room, have separate plates for each 
course, and various utensils for each dish, 
have snowy linen instead of oilcloth, — then 
there is more work, more strain, less real 
comfort. Much of what we call refinement is 
a cruel burden and entails a grievous waste 
of human energy and happiness. 

An important result of the sedentary life 


is constipation. Woman, under the best of 
circumstances, is more liable to this difficulty 
than her mate, just as the human being is 
more liable to it than the four-legged beast. 
Man's upright position has not been well 
adjusted by appropriate structures. Child- 
bearing, lack of vigorous exercise, the corset, 
and the hustle and bustle of the early morning 
hours so that regular habits are not formed, 
bring about a sluggish bowel. Indeed it is a 
cynicism amongst physicians that the proper 
definition of woman is "a constipated biped." 

While it is a lay habit to ascribe overmuch 
to constipation, it is also true that it does 
definite harm. For many people a loaded 
bowel acts as a mood depressant, as illustrated 
by the Voltaire story. For others it destroys 
the appetite and brings about an uneasiness 
that affects the efficiency. Whether there 
is a poisoning of the organism, an auto- 
intoxication, in such a condition is not a 
settled matter. But the importance of the 
constipation habit lies chiefly in its effect 
upon mood and energy, in its relation to 

These factors, the nature of housework, 
monotony and the results of sedentary life 


bear with especial weight upon the woman of 
little means. It is absolutely untrue that 
nervousness is a disease of wealth. There 
are cases enough where lack of purpose and 
lack of routine tasks, as in the case of wealthy 
women, lead to a rapid demoralization and 
deenergization. It is also true that the search 
for pleasure leads to a sterile sort of strenuous- 
ness that breaks down the health, as well as 
inflicting injury on the personality. 

Poverty is picturesque only to the out- 
sider. "It's hell to be poor" is the poor 
man's summary of the situation. There are 
serious psychical injuries in poverty which 
will demand our attention later, and still 
more serious bodily ones. In the case of 
the housewife, poverty on the physical side 
means (1) never-ending work; (2) no escape 
from drudgery and monotony ; (3) insufficient 
convalescence from the injuries of child- 
bearing ; (4) a poor home, badly constructed, 
badly managed, without conveniences and 

That there are plenty of poor women who 
bear up well under their burdens is merely a 
testimony to the inherent vitality of the race. 
A man w T ould be a wreck morally, physically, 


and mentally if he coped with his wife's 
burdens for a month. Either that or the 
housekeeping would get down to bare essen- 
tials. If a man kept such a house, dusting 
and cleaning would be rare events, meals 
would become as crude as the needs of life 
would allow, ironing and linen would be 
wiped off as non-essential, and the children 
would run around like so many little animals. 
In other words an integral part of what we 
call civilization in the home would disappear. 

Perhaps men would reorganize the home. 
The housekeeper of to-day is only in spots 
cooperative ; her social sense is undeveloped. 
Men might, and I think likely would, arrange 
for a group housekeeping such as that which 
they enjoy in their clubs. 

This digression aside, there are debilitating 
factors in the housewife's lot which need 
some amplification. We have referred to 
the insufficient time for convalescence from 
childbirth. There are sequela of childbirth, 
such as varicose veins, flat feet, back strain, 
that render the victim's life a burden. The 
rich woman finds it easy to secure rest enough 
and proper medical attention. But the poor 
woman, not able to rest, and with recourse 


either to her overbusy family doctor or to 
the overburdened, careless, out-patient de- 
partment of some hospital, drags along with 
her troubles year in and year out, becomes old 
before her time, and loses through constant 
pain and distress the freshness of life. 

It is impossible to separate the psychical 
factors from the physical, largely because 
there is no separation. One of the aims of 
a woman's life is to be beautiful, or at least 
good looking. From her earliest days this 
is held out to her as a way to praise, flattery, 
and power. It becomes a cardinal purpose, 
a goal, even an ideal. 

Unlike the purposes of men this goal is 
attained early, if at all, and then Nature or 
Life strip it away. The well-to-do woman 
or the exceptional poor woman may succeed 
in keeping her figure and her facial beauty 
for a relatively long time, though by the 
forties even these have usually given up the 
struggle. For the poor woman the fading 
comes early, — household work, bearing chil- 
dren, sedentary life, worry, and a non-appre- 
ciative husband bringing about the fatal 

I doubt if men see their youth slipping 


away with the anguish of women. To men, 
maturity means success, greater proficiency, 
more achievement, — means purpose-expand- 
ing. To women, to whom the main purpose 
of life is marriage, it means loss of their phys- 
ical hold on their mate, loss of the longed 
for and delightful admiration of others; it 
means substantially the frustration of purpose. 
And I have noticed that the very worst cases 
of neurosis of the housewife come in the early 
thirties, in women previously beautiful or 
extraordinarily attractive. They watch the 
crows'-feet, the fine wrinkles, the fat covering 
the lines of the neck and body with something 
of the anguish that the general watches the 
enemy cutting off his lines of communication 
or a statesman marks the rise of an implacable 

Popular literature, popular art, and popular 
drama, including in this by a vigorous stretch- 
ing of the idea the movie, are in a conspiracy 
against reality. This is of course because of 
the tyranny of the " Happy Ending." While 
the happy ending is psychologically and 
financially necessary, in so far as the pub- 
lishers, editors, and producers are concerned, 
what really happens is that the disagreeable 


phases of life, not being faced, persist. To 
have a blind side for the disagreeable does 
not rule it out of existence; in fact, it thus 
gains in effect. 

To say that housekeeping is looked upon 
essentially as menial, to say that it is monot- 
onous, that it is sedentary, and has the ill 
effects that arise from these characteristics, 
is not to deny that it has agreeable phases. 
It has an agreeable side in its privacy, its 
individuality, and it fosters certain virtues 
necessary to civilization. That I do not lay 
stress on these is because novelist, dramatist, 
and scenario author, as well as churchman and 
statesman, have always dwelt on these. The 
agreeable phases of the housewife's work do 
not cause her neurosis ; it is the disagreeable 
in her life that do. Or rather it is what any 
individual housewife finds disagreeable that 
is of importance, and it is my task to show 
what these things are, how they work, and 
finally what to do about it. 


Reaction to the Disagreeable 

A few preliminary words about the dis- 
agreeable in the housewife's lot will be of 

We may divide the things, situations, and 
happenings of life into three groups, — the 
agreeable, the indifferent, and the disagree- 
able. No two men will agree in detail in 
judging what is agreeable, indifferent, or 
disagreeable. There are as many different 
points of view as there are people, and in the 
end what is one man's meat may literally be 
another man's poison. There are, however, 
only a few ways of reacting to what one con- 
siders the disagreeable. The agreeable things 
of life do not cause a neurosis, though they 
may injure character or impair efficiency. 
And we may neglect the theoretical indifferent. 

1. A disagreeable thing may be so dis- 
astrous in our viewpoint as to cause fear. 


This fear may be expressed as flight, which 
is a normal reaction, or it may be expressed 
by a sort of paralysis of function, as the 
fainting spell, or the great weakness which 
makes flight impossible. Fear is a much 
abused emotion. People speak glibly about 
taking it out of life, on the ground that it is 
wholly harmful. "Children must not ex- 
perience fear; it is wrong, it is immoral; 
they should grow up in sunshine and glad- 
ness, without fear." A whole sect, many 
minor religions, take this Pollyanna attitude 
toward reality. 

As a matter of fact fear is a (I almost said 
the) great motive force of human life. Fear 
of the elements was the incentive to shelter; 
fear of starvation started agriculture and the 
storage of food; fear of disease and death 
gives medicine its standing; fear of the 
unknown is the backbone of conservatism, and 
fear of the rainy day is the source of thrift. 
Fear of death is not only the basis of religion, 
but of life insurance as well. Fear of the 
finger of scorn and the blame of our fellows is 
the great force in morality. And no amount 
of attempted unity with God will ever take 
the place of the injunction to fear Him ! 


2. While fear then is back of the construc- 
tive forces of life it works hand in hand with 
another emotion that is also greatly dis- 
paraged by sentimentalists, — anger. The 
disagreeable, by balking an instinct, by ob- 
structing a wish or purpose, may arouse 
anger. The anger may blaze forth in a 
sudden destructive fury in an effort to remove 
the obstacle, or it may simmer as a patient 
sullenness, or it may link itself with thought 
and become a careful plan to overcome the 
opposition. It may range all the way from 
the blow of violence to burning indignation 
against wrong and injustice ; it is the source 
of the fighting spirit. Without fear, purpose 
w r ould never be born ; without anger in some 
form or other it would never be fulfilled. 

3. But while fear and anger work well in 
succession, or at different times, when both 
emotions are awakened by some disagreeable 
situation or thing, when there is a helpless 
anger, when the instinct to fight is paralyzed 
by fear, when doubt arises, then there is 

Thus a hostile situation, an intensely dis- 
agreeable situation, may be met with energy : 
viz. planning, constructive flight, destructive 


action, or it may be met with a deener- 
gization, confusion, paralysis, hopeless anger. 
It may cause an intense inner conflict with 
high constant emotions, fatigue, incapacity 
to choose the proper action, and the peculiar 
agony of doubt. 

This last type of reaction is a very common 
one in the housewife. For the situation is 
never clear-cut for decision — there is the ideal 
implanted by training, education, social pres- 
sure, and her own desire to live in conformity 
with this ideal; there is opposing it disgust, 
anger, weariness, lack of interest that her 
house duties bring with them. This conflict 
leads nowhere so far as action is concerned, 
for she can neither accept nor reject the 

This is to say: The human being needs 
primarily a definite point of view, a definite 
starting place for his actions. Some belief, 
some goal, some definite purpose is needed 
for the rallying of the energy of mind and body. 
Drifting is intolerable to the acute, active 
mind bent upon some achievement before 
death. Man is the only animal keenly aware 
of his mortality, and consequently he is 
the only one to fear the passing of time. 


This passing of time can be received equably 
by the one conscious of achievement, or 
who has some compensation in belief and 
purpose; it becomes intolerable to those 
in doubt. 

Fundamentally one may say that neu- 
rasthenia and the allied diseases which we are 
here summing up as the nervousness of the 
housewife are reactions to the disagreeable. 
The fatigue, pains and aches, changes in 
mood and emotion are born of this reaction, 
except in those cases where they arise from 
definite bodily disease, and even here a 
vicious circle is established. The weakness 
and fatigue state, the consciousness of im- 
paired power brought about by sickness, are 
reacted to in a neurasthenic manner. It 
is not often enough realized by physicians 
that a physical defect or a physical injury 
may be reacted to so as to bring about 
nervous and mental symptoms; may cause 
the emotions of fear, hopeless anger, and 
sorrow ; may cause an agony of doubt. 

With these few words on types of reactions 
to the disagreeable let us turn again to the 
disagreeable factors in our housewife's life 
which may cause her neurosis. 


The child is the central bond of the home 
and is of course the biological reason for 
marriage. The maternal instinct has long 
been recognized as one of the great civilizing 
factors, the source of much of human sym- 
pathy and the gentler emotions. While the 
beautiful side of the mother-child relation- 
ship is well known and cannot be over- 
estimated, the maternal instinct has its fierce, 
its jealous, its narrow aspect. Love and 
sympathy for one's own in a competitive world 
have often as their natural results injustice 
and hardness for the children of others. 
While the best type of mother irradiates her 
love for her own into love for all children, it 
is not uncommon for women to find their 
chiefest source of rivalry in the progress and 
welfare of their children. 

Maternal devotion is largely its own reward. 
The child takes the maternal sacrifices for 
granted, and after the first few years the 
interests of parent and child diverge. There 
is a never-ending struggle between the rising 
and the receding generations, which is in- 
herent in the nature of things and will always 
exist wherever the young are free. All the 
world honors the mother, but few children 


return in anything like equality the love and 
sacrifices of their own mother. 

Is the maternal instinct waning in intensity 
in this period of feminization? There have 
always been some bad, careless, selfish 
mothers ; has their number increased ? Prob- 
ably not, yet the maternal instinct now has 
competition in the heart of the modern 
woman. The desire to participate in the 
world's activity, the desire to learn, to acquire 
culture, engenders a restless impatience w T ith 
the closed-in life of the mother-housewife. 
This interferes with single-minded mother- 
hood, brings about conflict, and so leads to 
mental and bodily unrest. Of course this 
interferes little or not at all with some, prob- 
ably most of the present-day mothers, but is 
a factor of importance in the lives of many. 

The nervous housewife has several diffi- 
culties in her relations to her children. 
These are of importance in understanding 
her and have been touched on before this, 
but it will be of advantage to consider them 
as a group. 

We have said that the opinion of obste- 
tricians is that the modern woman has more 
difficulty in delivering herself than did her 


ancestress. If this is true (and we may be 
dealing with the fact that obstetricians are 
often the ones to see the difficult cases, or 
that these stand out in their memories) there 
are several explanations. 

First, women marry later than they did. 
It may be said that the first child is easiest 
born before the mother is twenty-five years 
of age, and that from that time on a first 
child is born with rapidly increasing diffi- 
culty. The pelvis, like all the bony-joint 
structures of the body, loses plasticity with 
years, and plasticity is the prime need for 
childbearing. Similarly with the uterus, 
which is of course a muscular organ, but 
possesses an elastic force that diminishes as 
the woman grows older. 

Second, the vigor of the uterine contractions 
upon which the passage of the baby depends 
is controlled largely by the so-called sym- 
pathetic nervous system, though glands 
throughout the body are very important 
factors as well. This part of the nervous 
system and these glands are part of the 
mechanism of emotion as well as of child- 
bearing, and emotion plays a role of im- 
portance in childbearing. The modern 


woman fears childbearing as her ancestress 
did not, partly through greater knowledge, 
partly through her divided attitude towards 
life. * 

Having a harder time in childbearing means 
a slower convalescence, a need for more 
rest and care. Then nursing becomes some- 
how more difficult, more wearing to the 
mother; she rebels more against it, and yet, 
knowing its importance, she tries to "keep 
her milk." It often seems that the more 
women know about nursing, the less able 
they are to nurse, that the ignorant slum- 
dweller who nurses the child each time it 
cries and drinks beer to furnish milk does 
better than her enlightened sister who nurses 
by the clock and drinks milk as a source of 
her baby's supply. 

The feeling of great responsibility for her 
child's welfare that the modern woman has 
acquired, as a result of popular education in 
these matters, undoubtedly saves infants' 
lives and is therefore worth the price. A 
secondary result of importance, and one not 
good, is the added liability to fatigue and 
breakdown that the mother acquires. This 
factor we meet again in the next phase of our 


subject, the education and training of chil- 

Though the number of children has con- 
spicuously decreased, the care and attention 
given them has increased in inverse proportion. 
The woman with six children or more turned 
over the younger children to the older ones, 
so that her burden, though heavy, was much 
less than it may seem. Further, though she 
loved and cared for them, she knew far less 
of hygiene than her descendant ; she did not 
try to bring them up in a germless way; 
and her household activities kept her too 
busy to allow her to notice each running 
nose, or each "festering sore." Not having 
nearly so much knowledge of disease, she had 
much less fear and was spared this type of 
deenergization. Her daughter views with 
alarm each cough and sneeze, has sinister 
forebodings with each rash ; pays an enormous 
attention to the children's food, and through 
an increasing attention to detail in her child's 
life and actions has a greater liability to break 
under the greater responsibility and con- 

It must be remembered that the feeling of 
responsibility and apprehensive attention is 


not merely "mental." It means fatigue, 
more disturbance of appetite, and less restful 
sleep. These are things of great importance 
in causing nervousness ; in fact, they con- 
stitute a large part of it. 

Perhaps another generation will find that 
hygiene can be taught without producing 
fussiness and fear. Certainly popular edu- 
cation has its value, but it has a morbid 
side that now needs attention. This morbid 
side is not only bad for the mother but is 
unqualifiedly bad for the child. 

For the child of to-day, the center of the 
family stage in his attention, is often either 
spoiled or made neurasthenic by his treatment. 
Either he is frankly indulged, or else an over- 
critical attitude is taken toward him. "Bad 
habits must not be formed" is the actuating 
motive of the overconscientious parents, for 
they do not seem to know that the "trial 
and error" method is the natural way of 
learning. Children take up one habit after 
another for the sake of experience and dis- 
card them by themselves. For a child to 
lie, to steal, to fight, to be selfish, to be self- 
willed is not at all unnatural ; for him to have 
bad table manners and to forget admonition 


in general and against these manners in 
particular is his birthright, so to speak. 

Yet many a mother of to-day torments her 
child into a bad introspection and self-con- 
sciousness, herself into neurasthenia, and her 
husband into seething rebellion, because of 
her desire for perfection, because of her fear 
that a "bad act" may form into a habit and 
thence into a vicious character. 

Especially is this true of the oversesthetic, 
overconscientious types described in Chapter 
III. I have seen women who made the dinner 
table less a place to eat than a place where a 
child was pilloried for his manners, — pilloried 
into sullen, appetiteless state. 

So, too, an unfortunate publicity given to 
child prodigies brought with it for a short time 
an epidemic of forced intellectual feeding of 
children, that produced only a precocious 
neurasthenia as its great result. Similarly 
the Montessori method of child training 
which made every woman into a kindergarten 
teacher did a hundred times more harm than 
good, despite the merits of the system. That 
a child needs to experiment with life himself 
means that it will be a long time before the 
average mother will know how to help him. 


A factor that tends to perplex the mother 
and hurts the training of the child is her 
doubt as how "to discipline." Shall it be 
the old-fashioned corporal punishment of a 
past generation, the appeal to pain and blame ? 
Shall it be the nowadays emphasized moral 
suasion, the appeal to conscience and reason ? 
With all the preachers of new methods filling 
her ear she finds that moral suasion fails 
in her own child's case, and yet she is afraid 
of physical punishment. 

This is not the place to study child train- 
ing in any extensive manner, yet it needs be 
said that praise and blame, pleasure and 
pain, are the great incentives to conduct. 
One cannot drive a horse with one rein ; 
neither can one drive a child into social ways, 
social conformity by one emotion or feeling. 
Corporal punishment is a necessity, sparingly 
used but vigorously used when indicated. 
Of course praise is needed and so is reward. 

What is here to be emphasized is that a 
sense of great responsibility and an over- 
critical attitude toward the children is a 
factor of importance in the nervous state 
of the modern housewife. Increasing knowl- 
edge and increasing demand have brought 


with them bad as well as good results. Here 
as elsewhere a little knowledge is a danger- 
ous thing, but a more serious difficulty is 
this, — though fads in training arise that 
are loudly proclaimed as the only way, there 
is as yet no real science of character or of 
character growth. 

The tragedy of illness^ is acute everywhere, 
and the sick child is in every household. In 
many cases I have traced the source of the 
housewife's neurosis to the care and worry 
furnished by one child. There are truly 
delicate children who "catch everything", 
who start off by being difficult to nurse, and 
who pass from one infection to another until 
the worried mother suspects disease with every 
change in the child's color. A sick child is 
often a changed child, changed in all the 
fundamental emotions, — cranky, capricious, 
unaffectionate, difficult to care for. A sick 
child means, except where servants and nurses 
can be commanded, disturbed sleep, extra 
work, confinement to the house, heavy ex- 
pense, and a heightened tension that has as 
its aftermath, in many cases, collapse. The 
savor of life seems to go, each day is a throb- 
bing suspense. 


With recovery, if the woman can rest, in 
the majority of cases no marked degree of 
deenergization follows. But in too many 
cases rest is not possible, though it is ur- 
gently needed. The mother needs the care 
of convalescence more than does the child. 

There is an extraordinary lack of provision 
for the tired housewife. True there are sana- 
toria galore, with beautiful names, in pretty 
places, well equipped with nurses and doctors 
to care for their patients. But these are pro- 
hibitive in price, and at the present writing 
the cheapest place is about forty dollars 
per week. This rate puts them out of the 
reach of the great majority who need them. 

Moreover, where there are small children 
and where there is no trusty servant or some 
kindly relative or friend it seems impossible 
for the housewife to leave the home. Her 
husband must work daily for their bread 
and unless they are willing to turn to the char- 
itable organizations, it is necessary for the 
housewife to carry on, despite her fatigue. 
So at the best she gets an hour or two extra 
rest a day, takes a "little tonic" from the 
family doctor and gets along with her pains, 
her aches, and moods as best she can. 


But the sick do not always recover. For- 
tunately, the average human being grieves 
a while over death, but the life struggle soon 
absorbs him, and the bereavement itself 
becomes a memory. But now and then one 
meets mothers whose griefs and deprivations 
seem without end. No religion, no philosophy 
can bring them back into continuity with their 
lives. They go about in a sorrowful dream, 
hugging their affliction, resenting any effort 
to comfort or console; without interest in 
the daily task or in those whom they should 
love. They offer the severest problem in 
readjustment, in reenergization, for they 
actively resent being helped. Sometimes one 
believes their grief is an effort to atone for 
neglect real or fancied, a self -punishment 
which is not remitted until full atonement 
has been made. 

Aside from the physical difficulties in the 
bearing and rearing of children, and in addi- 
tion to the ordinary mental difficulties, such 
as judging what discipline to use, there are 
especial problems of some importance. Men 
vary in character from the saint to the 
villain, in ability from the genius to the idiot. 
The children they once were vary as much. 


There are children who go through the worst 
of homes, the worst of environments, the 
worst of trainings, — and come out pure gold, 
with characters all the better for the struggle. 
There are others whom no amount of love, 
discipline, training, and benefits help; they 
are despicable from the ordinary viewpoint 
from the first of life to the last. Some chil- 
dren, adversely situated as to poverty and 
health, become geniuses, and their reverse 
is in the poor child whom heredity, early 
disease, or some freak of nature dooms to 

The heart of the mother is in her child ; she 
glories in its progress, and she refuses to see 
its defects until they glare too brightly to be 
overlooked. Then she has a heartbreak all 
the more bitter for her maternal love. 

It is the incorrigibly bad child and the 
mentally deficient child who evoke the sever- 
est, most neurasthenic reaction on the part 
of the housewife. Not only is pride hurt, 
not only is the expanded self-love injured, 
but such children are a physical care and 
burden of such a nature as to outbalance 
that of three or four normal children. 

The bad child, ^egoistic, undisciplinable, 


destructive, and quarrelsome, or the child who 
cannot be taught honesty, or the one who 
continually runs away, is an unending source 
of "nervousness" to his mother. As time 
goes on and the difficulty is seen to be funda- 
mental, a battle between hostility and love 
springs up in the mother's breast that plays 
havoc with her strength and character. The 
very worst cases of housewife neurosis are 
seen in such mothers; the most profound 
interference with mood, emotion, purpose, and 
energy results. 

! Similarly, with the mother of the feeble- 
minded child. At first the child is viewed 
as a bit slow in walking, talking, in keeping 
clean, and the mother explains it all away on 
this ground or that. A previous illness, a 
fall in which the head was hurt, difficulty with 
the teething, diet, etc., all receive the blame. 
Alas! In the course of time the child goes 
to kindergarten and the terrible report comes 
back that "the child cannot learn, is clumsy, 
etc.", and the teacher thinks he should be 
examined. Then either through the exami- 
nation or through the pressure of repeated 
observations mother love yields to the truth 
and feeble-mindedness is recognized. 


There are plenty of women who, with this 
fact established, adjust themselves, make up 
their minds to it. But others find that it 
takes all the pleasure out of their lives, 
become morbid, and do not enjoy their 
normal children. For with all due respect 
to eugenics and statistics I am convinced 
that the most of feeble-mindedness is accidental 
or incidental, and not a matter of heredity. 
Once a mother gets imbued with the notion 
that the condition is hereditary, she falls 
into agonies of fear for her other children. 
In my mind there is a thoroughly reprehen- 
sible publicity given to half-baked work in 
heredity, mental hygiene, and the like that does 
far more harm than good and interferes with 
the legitimate work. 

There is no offhand solution for the case 
of the incorrigible boy or girl. Of course 
the largest number sooner or later reform, 
sometimes overnight, and in a way to remind 
one of the religious conversions that James 
speaks of in his "Varieties of Religious 
Experiences." So long as a child has a social 
streak in his make-up, so long as he at least 
is responsive to the praise and blame of others 
and understands that he does wrong, so 


long may one hope for him. But the child 
to whom the opinion of others seems of no 
value, who follows his own egoism without 
check or control by the accepted standard of 
conduct, by the moral law, by the praise and 
blame of those near to him, is almost hope- 
less. Some day intelligence may keep him 
out of trouble, but by itself it cannot change 
his nature. 

It is not sufficiently realized that while 
there has been a rise of feminism there has 
also been a great change in the status of 
children, a change that makes their care far 
more difficult than in the past. They have 
risen from subordinate figures in the house- 
hold, schooled in absolute obedience, "to 
be seen and not heard," to the central figures 
in the household. One of the strangest of 
revolutions has taken place in America, taken 
place in almost every household, and without 
the notice of historians or sociologists. That 
is because these professional students of 
humanity have their attention focused on 
little groups of figures called the leaders, and 
not nearly enough on that mass which gives 
the leaders their direction and power. 

The age of the child ! His development 


parallels that of women, in that an in- 
dividualization has taken place. In the past 
education and training took notice of the 
child-group, not of the individual child. 
But child-culture has taken on new aspects, 
punishment has been largely superseded, in- 
dividual study and treatment are the thing. 
Personality is the aim of education, especial 
aptitudes are recognized in the various types 
of schools that have arisen : commercial, 
industrial, classical; yes, and even schools 
for the feeble-minded. 

All this is admirable, and in another cen- 
tury will bring remarkable results. Even 
to-day some good has come, but this is largely 
vitiated by other influences. 

Aside from the fact that the attention paid 
the child often increases his self-importance 
and makes his wishes more capricious, there 
are factors that tend to rob him of his naivete. 

These factors are the movies, the news- 
papers, and the spread of luxurious habits 
amongst children. 

The movies are marvelous agents for the 
spread of information and misinformation. 
Because of the natural settings they give 
to the most absurd and unnatural stories, 


their essential falsity and unreality is often 
made the more pernicious. Their possibilities 
for good are enormous, their actual perform- 
ance is conspicuously to lower the public 
taste, to create a habit which discourages 
earnest reading or intelligent entertainment. 
For children they act as a stimulant of an 
unwholesome kind, acquainting them with 
realistic crime, vice, and vulgarity, giving 
them a distaste for childlike enjoyment. One 
sees nowadays altogether too often the 
satiated child who seeks excitement, the cyni- 
cal, overwise child filled with the lore of the 

In similar fashion the "comic" cartoons of 
the newspapers have an extraordinary fas- 
cination for children. Every child wants to 
read the funny page, though the funny page 
is not for childish reading. The humor is 
coarse, slangy, and distinctly vulgar; very 
clever frequently and thoroughly enjoyable 
to those whom it cannot harm. 

If the historians of, say, 4500 a.d. were by 
chance to get hold of a few copies of our news- 
papers of 1920 they might legitimately con- 
clude that the denizen of this remote period 
expressed surprise by falling backward out of 


his shoes, expressed disagreement by striking 
the other person over the head with a brick or 
a club ; that women were always taller than 
their mates and usually "beat them up"; 
that all husbands, especially if elderly, chased 
after every young and pretty girl. They 
might conclude that the language of the mass 
of the people was of such remarkable types 
as this : "You tell them Casket, I 'm Coffin", 
or "the Storm and Strife is coming ; beat it !" 

No one I think enjoys the comic page more 
than the present writer, — yet it spreads a 
demoralizing virus amongst children. Of 
what use is it to teach children good English 
when the newspaper deliberately teaches them 
the cheapest slang? Of what use is it to 
teach them manners and kindliness when the 
newspaper constantly spreads boorishness 
and "rough house" conduct? Of what use 
is it to raise taste when this is injured at 
the very outset of life by giving bad taste a 
fascinating attraction ? 

Throughout the community there is a stir 
and excitement that is reflecting on the 
children. There are so many desirable 
luxuries in the world now, so many revealed 
by movie and symbolized by the automobile, 


the cabaret, the increasing vulgarity of the 
theater (the disappearance of the drama and 
the omnipresent girl and music show), a 
restless search for pleasure throughout the 
community even before the War, have not 
missed the child. 

All these things make the lot of the house- 
wife harder in so far as the training of her 
children is concerned. She is dealing with a 
more alert, more sophisticated, more sen- 
suous child, — and one who knows his place 
and power. The press and the theater both 
have knowledge of this and a recent witty 
play dealt with the sins of the children, 
paraphrasing of course the classic of a bygone 
day, "Sins of the Fathers." And a wise old 
gentleman said to his grandson recently, 
when the lad complained about his mother, 
"Of course you are right. Every son has a 
right to be obeyed by his mother." 

I am by no means a pessimist. Every for- 
ward step has its bad side, but nevertheless is 
a forward step. It is in the nature of things 
that we shall never reach a millennium, 
though we may considerably improve the 
value and dignity of human life. Democ- 
racy has a role in the world of great im- 


portance, — but the spread of education and 
opportunity to the mass may make it more 
difficult for the best ideals and customs to 
survive in the avalanche of mediocrity that 
becomes released by the agencies that profit 
by appealing to the mass. So, too, the rise 
of the woman and child bring us face to face 
with new problems, which I think are less 
difficult problems than those they have super- 
seded and replaced, but which are yet of 

And a great problem is this: how to in- 
dividualize the child and keep from spoiling 
him ; how to give him freedom and pleasure, 
and keep him from sophistication. 


Poverty and Its Psychical Results 

In the story of Buddha it is related that it 
was the shock of learning of the existence of 
four great evils which aroused his desire to 
save mankind. These evils were Old Age, 
Sickness, Death, and Poverty. Theologians 
and the sentimentalists are unanimous in 
their praise of poverty, — the theologians 
because they seek their treasure in heaven, 
and the sentimentalists because they are in- 
corrigible dodgers of reality, because they 
cannot endure the existence of evil. But 
Buddha knew better, and the common sense 
of mankind has shown itself in the desperate 
struggle to reach riches. 

We have spoken of the part played by the 
physical disadvantages of poverty in causing 
the nervousness of the housewife. It is not 
alleged or affirmed that all poor housewives 
suffer from the neurosis, — that would be 


nonsense. But poor food, poor housing, poor 
clothing, the lack of vacations, the insufficient 
convalescence from illness and childbirth are 
not blessings nor do they have anything but 
a bad effect, an effect traceable in the condi- 
tions we are studying. 

Furthermore, the woman who does all her 
own housework, including the cooking, scrub- 
bing, washing, ironing, and the multitudinous 
details of housekeeping, in addition to the 
bearing and rearing of children, does more 
than any human being should do. It is very 
well to say, "See what the women of a past 
generation did," but could we look at the 
thing objectively, we would see that they 
were little better than slaves. That is the 
long and short of it, — the Emancipation 
Proclamation did not include them. 

Aside from the physical effects of poverty 
on the housewife, there are factors of psychical 
importance that call for a hearing. After 
all, what is poverty in one age is riches in 
another; what is poverty for one man is 
wealth to his neighbor. More than that, what 
a man considers riches in anticipation is 
poverty in realization. Here again we deal 
with the mounting of desire. 


The philosophical, contented woman, satis- 
fied with her life even though it is poor, is 
exempted from one great factor making for 
breakdown. Contentment is the great shield 
of the nervous system, the great bulwark 
against fatigue and obsession. But content- 
ment leads away from achievement, which 
springs from discontent, from yearning desire. 
Whether civilization in the sense of our 
achievements is worth the price paid is a 
matter upon which the present writer will not 
presume to pass judgment. Whether it is 
or not, Mankind is committed to struggle 
onward, regardless of the result to his peace 
of mind. 

There are two principal psychical injuries 
with poverty — fear and worry — and we 
must pass to their consideration as factors 
in the neuroses of some women. 

Worry is chronic fear directed against a 
life situation, usually anticipated. Man the 
foreseeing must worry or he dies, — dies of 
starvation, disease, disaster. It is true that 
worrv mav be excessive and directed either 
against imaginary or inevitable ills ; ills that 
never come, ills that must come, like old age 
and death. 


Men in comfortable places cry "Why 
worry?" meaning of course that the most of 
worry is about ills that are never realized. 
That is true, but the person living just on the 
brink of disaster, ruined or made dependent 
on charity by unemployment, a long illness, 
or any failure of power and strength, cannot 
be as philosophical as the man fortified by a 
nice bank account or dividend-paying invest- 
ments. These well-to-do advisers of the poor 
remind one of the heroes of ancient fables 
who, having magic weapons and impenetrable 
armor, showed no fear in battle. One wonders 
how much courage they would have had if 
armed as their foemen were. 

For the poor housewife who sees no escape 
from poverty, whose husband is either a work- 
man or a struggling business man always on 
the edge of failure, life often seems like a wall 
closing in, a losing battle without end. 

Especially in the middle-aged, in those ap- 
proaching fifty, does this happen. Aside from 
the condition produced by "change of life", 
the so-called involution period, there is a 
reaction of the "time of life" that is found 
very commonly. For old age is no longer 
far off on the horizon ; it is close at hand, 


around the corner, and the looking-glass pro- 
claims its coming. The woman wonders 
whether her husband will long be able to keep 
up, — and then "what will become of us ?" 

To be thrown on the benevolence of children 
is a sad ending to independent natures, to 
people of experience. Crudely put, those 
who have been dependents are now sus- 
tainers ; those who have been led now guide ; 
the inferiors are the superiors. This is not 
cynicism, for with the best intentions in the 
world, if the children are also poor, the care 
of the parents is a burden that they cannot 
help showing, sooner or later. 

Looking forward to such an ending to the 
hard work and struggle of a lifetime is part 
of the worry of poverty, to be classed with the 
fear of sickness and unemployment. 

We may loudly proclaim that one honest 
man is as good as another, that character is 
the measure of worth, that success cannot be 
measured by money. These things are true ; 
the difficulty is not to make people believe 
it, it is to make people feel it. Deeply in- 
grained in poverty is not alone to be deprived 
of things desired ; more important is the 
feeling of inferiority that goes with the condi- 


tion. Only in the Bohemia of the novelists 
do the poor feel equal to the rich. 

One of the fundamental strivings of the 
human being is the enlargement of the self- 
feeling, which fundamentally is the wish to be 
superior, to have the admiration and homage 
of others. All daydreaming builds this air 
castle ; all ambition has this as its goal. No 
matter how we disguise it to ourselves and 
others, the main ends of purpose are power 
and place. True, we may wish for power and 
place so as to help others ; we may wish them 
as the result of constructive work and achieve- 
ment, but the enlargement of self-feeling is 
the end result of the striving. 

To be poor is to be inferior in feeling and 
applies equally to men and women. Man is 
a competitive-social animal and competes in 
everything, from the cleverness and beauty 
of his children to the excellence of his taste in 
hats. Money has the advantage of being the 
symbol of value, of being concrete and definite, 
and of having the inestimable property of 
purchasing power. 

Now woman is as competitive as her mate. 
A housewife vies with her neighboring house- 
wives in her clothes, her good looks, her 


youth, her husband, her children, her home, 
her housekeeping, her money, — vies with 
her in folly as well as in wisdom. How much 
of the extravagance of women (and here is a 
difficulty to be dealt with later) arises from 
rivalry only the tongues of women could tell, 
but it is safe to say that the greater part of it 
has this origin. 

Jealousy and envy are harsh words, yet 
they stand for traits having a great psycho- 
logical value. Part of the impetus for effort 
rises from these feelings, and an incredibly 
large part. Many a man who bends unremit- 
ting in his effort has in mind some man of 
whose success he is envious, or whose efforts 
he watches with a jealousy hidden almost 
from himself. 

Upon women these feelings play with devas- 
tating force. One may be satisfied with what 
he has until some one else he knows gets more ; 
that is to say, the causes of most of the dis- 
satisfaction and discontent of the world are 
envy and jealousy. In many cases it may be 
a righteous sort of jealousy or envy. A 
woman, especially because she is a rival of 
her fellow-woman mainly in small things, 
becomes acutely miserable when she is out- 


stripped by her neighbor and especially if she 
is passed by her relatives and intimate friends. 

Poverty is especially hard on those intensely 
ambitious for their children. "They must 
have the education I did not have ; they must 
have a good time in life which I never had; 
I don't want them to be poor all their lives 
like we are." Here is the woman who works 
herself to the bone, yet is content and well save 
for her fatigue, if her children respond to her 
efforts by success in study and by ambitious 
efforts of their own. But if the struggling 
mother is so unfortunate as to have drawn in 
Nature's lottery an unappreciative or a weak- 
minded child, then the breakdown is tragic. 

A poor man is much more apt to be phil- 
osophical about poverty for his children than 
his wife is. He is willing to do what he can 
for them, but he is more apt to realize what 
mother love is blind to, — that the average 
child is unappreciative of the parents' efforts 
and takes them for granted. The man is 
more apt to think and say, "Let them stand 
on their own feet and make their own way; 
it will do them good." The mother usually 
longs to spare her children struggle, the father 
rarely shares this desire except in a mild way. 


It may be that there was a time when classes 
were more fixed, that poverty had less of 
humiliation and blocked desire than it has at 
present. That society of all grades is restless 
with the desire for luxury seems without doubt. 
How profoundly the psychology of the masses 
is being altered by education, by the news- 
paper, the magazine, the movie, the automo- 
bile, the fashion changes that make a dress 
obsolete in a season and above all the depart- 
ment store and the alluring advertisement, 
no one can hope to even estimate. Modern 
capitalism reaps great wealth by developing 
the luxurious, the spendthrift tastes of the 
poor. It would be a peculiar poetic justice 
that will make that development into the 
basis of revolution. 

The women of the poor are perhaps even 
more restless than the men. In fact, it is 
the women that set the pace in these matters. 
This is because to woman has fallen the spend- 
ing of the family funds, a fact of great impor- 
tance in bringing about discord in the house. 
As the shopper the poor woman now sees the 
beautiful things that her ancestors knew 
nothing of, since there were no department 
stores in those days. To-day desires are 


awakened that cannot be fulfilled ; she sees 
other women buying what she can only long 
for, and an active discontent with her lot 

Unphilosophical this, and severely to be 
deprecated as unworthy of woman. This 
has been done so often and so effectively ( ?) 
by divines, reformers, press, that a mere 
physician begs leave to remark that it is a 
natural sequence of the publicity luxury 
to-day has. The most successful commercial 
minds of America are in a conspiracy against 
the poor Housewife to make her discontented J 
with her lot by increasing her desires; they are 
on the job day and night and invade every 
corner of her world; well, they have suc- 
ceeded. The divines, etc., who thunder 
against luxury have no word to say against 
the department store and the advertising 


The Housewife and Her Husband 

The husband differs from the wife in this 
fundamental, — that essentially he is not a 
house man as she is a house woman. For the 
man the home is the place where he houses 
his family and where he rests at night. Here 
also he spends his leisure time in amount 
varying with his domesticity. Man writes 
songs and books about the home, but the 
woman lives there. Perhaps that is why 
women have not written sentimental verse 
about it. 

Marriage is variously regarded. "It is a 
sacrament, a religious sanction, and not to 
be dissolved by anything but Death." So say 
a very large group of our people. "It is a 
contract, governed by law, entered into under 
certain conditions and to be dissolved only 
by law." This is the attitude of practically 
all the governments of the world and rapidly 


is becoming the dominant point of view. 
Though the religious combat this conception 
of marriage, no marriage is legal on religious 
sanction alone, and the increase of divorce 
among those claiming to be Catholics is an 
undisputed fact. 

It is only in the last century that the con- 
tract side of marriage has been emphasized 
and become dominant. There has resulted 
a conflict between the sacramental, sacred 
point of view and the secular. This conflict, 
like all other social conflicts, is a part of the 
inner life of most of the men and women of 
this generation, influencing their attitude 
toward marriage, the home, the mate. 

For when we say a thing is part of the 
"spirit of the times" we mean merely that 
arising as a development of, or a change from, 
old ideas in the minds of leaders, it has become 
propagated among the mass. It has become 
part of their thought, incentive to their action, 
source of their energies. 

Thus sentiment and religion proclaim the 
sacredness of marriage, its eternal nature, its 
indissolubility. The law asserts it to be a 
civil relationship, to be made or unmade by 
law itself; experience teaches that if it is 


sacred, then sacredness includes folly, indis- 
cretion, brutality, and crime. Therefore the 
marriage relationship has become a source of 
conflict for our times, yvith. opposing cham- 
pions shouting out their point of view, with 
books, the movies, the press, the stage, with 
daily experience adducing cases. The scene 
of conflict is in the moods and emotions of 
all of us. 

This divided view is particularly the atti- 
tude of women and becomes part of the 
neurosis of the housewife. 

After all a woman does not marry an insti- 
tution; she marries a man with whom she 
lives, sharing his life. In the natural course 
of events she becomes the mother of . the 
children to whom he is father. We may 
dismiss as nonimportant the occasional freak 
marriage where a man and woman live apart, 
have no children and meet occasionally, — 
for obvious purposes. Such a marriage is 
not only sterile biologically, not only empty 
of the virtues of marriage, but encounters 
none of its difficulties. 

This intimate individual relationship makes 
marriage when complete and successful the 
happiest human experience. Soberly speak- 


ing, it is then the flower of existence, satisfying 
biologically and humanly, giving peace and 
satisfaction to body and mind. This is the 
ideal, the "happy ending" at which most 
romances, novels, plays, and all the daydreams 
of youth leave us. Warm, cozy, intense 
domesticity, — where passion is legitimate 
and love and friendship eternal ; where chil- 
dren play around the hearth fire; of which 
death only is the ending ! 

This ideal is not realized largely because 
no ideal is. How often is it closely approxi- 
mated? Experience says seldom. That im- 
plies no reproach against marriage, for we are 
to judge marriage by the rest of life and not 
by an ideal. A world in which great wars 
occur frequently, in which economic conflict 
is constant, in which sickness and disaster 
are never absent; where education is occa- 
sional, where reason has yet to rule in the 
larger policies and where folly occupies the 
high places, — why expect marriage to be 
more nearly perfect than the life of which 
it is a part? To be reasonably comfortable 
and happy in marriage is all we may expect. 

What are the difficulties confronting the 
partners which impede happiness and espe- 


cially which bring the neurosis of the house- 
wife ? For after all we can only examine the 
field for our own purpose. 

We may divide the difficulties as follows 
from the standpoint of the neurosis of the 
housewife : 

1 . Those that arise from the sex relationship 

2. Those that arise from conflicts of will, 
purpose, ideas. 

3. Those that arise from the types of 

4. Those that arise from the types of wives. 
(This has already been considered under the 
heading Types Predisposed to the Neurosis.) 

Before we go on to the consideration of 
these various factors we must repeat what 
has been emphasized frequently in this book. 

That the change in the status of woman 
implies difficulty in the marriage relationship. 
If only one will is expected to be dominant in 
the household, the man's, then there can arise 
no conflict. If the form of the household is 
unaltered, but if the woman demands its 
control or expects equality, then conflict 
arises. If a woman expects a man to beat 
her at his pleasure, as has everywhere been 


the case and still is in some places, if she con- 
siders it just, brutality exists only in extremes 
of violence. If she considers a blow, or even 
a rough word, an unendurable insult, then 
brutality arises with the commonest disagree- 
ment. In other words, it is comparatively 
easy to deal with a woman expecting an 
inferior position, whose individual tastes, wills, 
ideas, and ideals have never been developed, 
— the ancient woman ; . it is very much more 
difficult to deal with her modern sister. 

Happily the day is passing when prudery 
governed the discussion of sex. Lewdness 
exists in concealment, suggestion is more 
provocatory than frankness. The morbidness 
of men who condemned themselves to celibacy 
has influenced the world ; their fear of sex led 
to a misguided silence shrouding the wrecks 
of many a life. 

The sex relationship is the basis of marriage. 
The famous couplet of Rosalind still holds 
good. The sex instinct (or rather instincts, 
for coupled with sex-desire is love of beauty, 
admiration, joy of possession, triumph, etc.) 
has the unique place of being more regulated 
by law and custom than any other basic 
instinct. The law holds that no marriage 


is consummated until the sex act has taken 
place, regardless of the words of preacher or 
State official. The happiness of the first 
year or years of married life is mostly in its 
voluptuous bonds, for companionship and 
comradeship have really not yet arisen. Com- 
plementary to this it may be said that much of 
married misery, especially for the woman, 
arises from the first marital embrace. 

This last is because of the ignorance of men 
and women, an ignorance wholly due to prud- 
ery. The majority of women have been 
chaste before marriage ; the majority of men 
have not. One would expect therefore knowl- 
edge of men, the knowledge of experience. 
But the experience has been gained with 
women of a certain type and has not equipped 
the man to deal with his wife. Though most 
women know in advance what is expected of 
them, some are even ignorant of the most 
elemental facts of sex, and even those who 
know are unprepared for reality. 

Too frequently the man regards himself as 
a Grand Seigneur with a paramount "Jus 
Primis Noctis." True, the majority of men 
are abashed in the presence of innocence and 
deal gently with it, — but others follow in a 


repellent way their instinct of possession. 
Any neurologist of experience has cases where 
sexual frigidity and neurasthenia in a woman 
can be traced back to the shock of that all- 
important first night. 

There are savage races in which preparation 
for marriage is an elementary part of educa- 
tion. We need not follow them into absurd- 
ity, but more than the last silly whispered 
words to bride and groom at the ceremony is 
necessary. A formal antenuptial enlighten- 
ment, frank and expert, is needed by our 

The sex appetite varies as widely as any 
other human character. Generally speaking, 
it is believed that sexual passion in women is 
more episodic than in men, often relating to 
the menstrual period. In many cases it does 
not develop as a conscious factor in the 
woman's life until after marriage, and some- 
times not until the first child is born. Cer- 
tainly desire in the girl is a more generalized, 
less local, less conscious excitement than it is 
in the boy who cannot misunderstand his 
feelings. I think it may safely be said that 
allowing for the freedom of boys and men, 
there is native to the male a more urgent 


passion than to the female. This would be 
biologically necessary, since upon him devolves 
not only courtship but the fundamental 
activity in the sexual act. A passionless 
woman may have sexual relation, a passionless 
man cannot. 

The disparity in sex desire between a hus- 
band and wife may be slight or great. No 
statistics on the subject will ever be gathered, 
from the very nature of the facts, but it is 
safe to say that much more disparity exists 
than is suspected. And likewise it causes 
more trouble than is suspected. Where the 
virility of the mate is inadequate there breeds 
a subtle dissatisfaction that may corrode do- 
mestic happiness and bring about conflict on 
subjects quite remote from the real issue. 
Contrariwise, to have relations forced or 
coaxed on one where desire is lacking brings 
about disgust, nervous reactions, fatigue of 
marked nature. 

A woman sexually well mated often clings 
beyond reason to an unworthy mate. Many 
an inexplicable marriage, many a fantastic 
loyalty of a good woman to a bad man has its 
origin where it is least expected, in the sex 
attachment. Demureness of appearance, re- 


finement of manner, noble ideals are not at all 
inconsistent with powerful sex feeling. There 
is no reason why strong, well-controlled pas- 
sion should be considered anything but a 
virtue, why the pleasure of the sexual field 
should, under the social restriction, be re- 
garded as impure. 

Too often the latter is the case. Fantastic 
puritanical ideas often govern both men and 
women. I have in mind several couples who 
desired to live continent until such time as 
children were desired. The biological reasons 
for the sexual relations seemed to them the 
only "pure" reasons. Needless to say the 
resolution broke down under the intimacy of 
one roof, but meanwhile a conflict was 
engendered that took some vigorous counsel 
to dissipate. 

This purely occidental idea that sexual 
pleasure is somehow unworthy is responsible 
for a disparity of a further kind. There are 
parts of the physical side of love in which the 
majority of men need education, though in 
the well-adjusted married life the proper 
knowledge comes. Nature has not completely 
adjusted the sexes to one another; it is the 
part of the man to bring about that adjust- 


ment. This part of the adjustment need not 
here be detailed ; the books of Havelock Ellis 
are explicit on the matter. Certainly no 
small share of the difficulties of our housewife 
result, for it is a law that excitement without 
gratification brings about nervous instability. 

Whether or not the American domestic life 
is too intimate, too constant, is an important 
question. For the majority of people, after 
the first ecstasy of the bridal year, separate 
rooms might be better than a single chamber 
occupied together. There are people to whom 
one bed and one room is symbolic of their 
close unity, of their joined lives, who find 
comfort and companionship in the knowledge 
that their life partner sleeps beside them. 
Where sexual compatibility or adjustment 
exists, there is nothing but commendation for 
this arrangement. Where it does not exist, 
the separate chambers are better for obvious 

A development of recent times is the rapidly 
increasing use of what are politely known as 
birth-control measures. This development is 
rapidly changing the number of births in the 
community to a figure below that necessary 
for the perpetuation of the race. We are not 


concerned here with the morality or immoral- 
ity of these measures. Modern woman un- 
doubtedly will continue to take the stand that 
childbearing should be voluntary, that in- 
voluntary motherhood is incompatible with 
her dignity and status as a person. In this, 
through the increasing cost of living as well 
as sympathy with her attitude, she will be 
backed by her husband. I predict without 
fear that Church and State will have to adjust 
themselves to this situation. 

The fear of pregnancy has brought about 
this situation, that many a woman undergoes 
an agony of symptoms which is only relieved 
w T hen her monthly function appears. This 
fear makes the sexual relationship a risk 
almost outweighing its pleasure. The no- 
toriously "unsafe" character of the contracep- 
tive measures has only diminished this fear, 
not completely allayed it. 

Moreover the contraceptive measures, ac- 
cording to the law that every " solution " breeds 
new problems, have their place in causing 
nervousness. Rarely do these measures re- 
place the natural act in satisfaction. Further, 
some are unable to conquer their repugnance 
and disgust and some are left excited and 


unsatisfied. Vasomotor disturbances, neuras- 
thenic symptoms, obsessions, and hysterical 
phenomena occur in many women as well 
as in some men. One of the stock questions 
of the neurologists when examining a married 
man or woman complaining of neurasthenic 
symptoms relates to the contraceptive meas- 
ures used. The channel of discharge of 
sexual excitement is race old. And this new 
development blocks that channel. For many 
persons this is sufficient to deenergize the 

At the present time there are two trends in 
the sex sphere, so far as women are concerned. 
There is the masculine trend, which is usually 
called feminism. Women tend to take up the 
work formerly exclusively belonging to men ; 
they tend to dress more like men, with fiat 
shoes, collars and ties, and tailor-made clothes. 
They take up the vices of men, — smoking, 
drinking, — are building up a club life, live in 
bachelor apartments, call each other by their 
last names, etc. 

Whether with this goes a greater sexual 
license or not it is difficult to say. The 
observers best qualified to comment think 
there has been a decrease in female chastity, 


— that the entrance of women in industrial 
life, the growth of the cities, the increase in 
automobiles, the greater freedom of women, 
the dropping of restraint in manner and 
speech, have brought women's morals some- 
what nearer to men's. 

The other trend, not entirely separate 
except for externals, is marked by a hyper- 
sexuality, an emphasis of femaleness. This 
is by far the more common phenomenon and 
probably more widely spread through society. 
The dress of women in general is more daring, 
more designed for sex allurement than for a 
century past. Women paint and powder in 
a way that only the demimonde did a genera- 
tion ago, reminding one of the ladies of the 
French Court in the eighteenth century. 
Further, the plays of the day would be called 
mere burlesque a generation back ; the girl 
and music show has the center of the stage, 
and the drama in America has almost dis- 
appeared. There is an epidemic of magazines 
that flirt with the risque ; with titles that are 
sometimes much more clever than their 

Such eras have been with us before this, 
have come and gone. It is doubtful if they 


ever affected so large a number of people. 
The excitement of the daily life is increased 
in a sexual way, and this brings an unrest that 
reacts on the anchor of the home, the house- 
wife. She too tugs at her moorings; life 
must be speeded up for her too as well as for 
the younger and unattached women. She 
becomes more dissatisfied and therefore more 

Altogether the sexual relationship of modern 
marriage needs a candid examination. No 
drastic change is indicated, but education in 
sexual affairs for men and women is a need. 
Even the prudish admit the pleasure of the 
sex-life, and that seems to be their funda- 
mental aversion to it. Most of the advice 
and injunctions in the past seem to have 
come from the sexually abnormal. It is time 
that this was changed; in fact, it is being 
changed. The danger lies in a swing to 
extremes, in leaving the fields to those who 
think reform lies in the abolition of restraint, 
in the disregard of all social supervision and 
obligation. Free love is more disastrous if 
possible than prudery. 


The Housewife and Her Household 

The problems of life are not all sexual, 
and in fact even in the relations of men and 
women there are more important factors. 
After all, as Spencer pointed out in a mar- 
velous chapter, love itself is a composite of 
many" things, some, of the earth, earthy, and 
some of the finest stuff our human life holds. 
The aspirations, the ideals, the yearnings of 
the girl attach themselves to some man as 
their fulfillment; the chivalrous feelings, the 
desire to protect and cherish, the passion for 
beauty of the man lead to some girl as their 
goal. There are few for whom the glow and 
ardor of their young love bring no refine- 
ment of their passion ; there are few who have 
not felt a pulsating unity with all that love 
and live, at least for some ecstatic moments. 
Something of what James has so beautifully 


designated as the "aura of infinity that hangs 
over a young girl" also lingers over the love 
of men and women. 

All the cynics and epigram makers in the 
world agree that love ends with marriage, 
and this not only in modern times but even 
back into those days of the French Court of 
Love, when Margaret de Valois decided that 
the lover had more claims than the husband. 
Romance dies with marriage is the plaint of 
poet and novelists; the charm of woman 
disappears with her mystery, with possession. 
And the typical humorist speaks of the curl 
papers and kimono of the wife, the snores and 
unshaven beard of the husband. "Famil- 
iarity is the death of passion" is the theme 
of countless writers who bemoan its passing 
in the matrimonial state. 

How much harm the romantic tales have 
done to marriage and the sober-satisfying 
everyday life, no one can estimate, no one 
can overestimate. Romanticism, which ex- 
tols sex as the prime and only thing of life, 
prudery which closes its eyes to it and makes 
sour faces, need special places in Dante's 
Inferno. Neither has dealt with reality, — 
reality, which is satisfying and pleasant unless 


examined with the prejudices instilled by the 
hypersexual romance writer and the perverted 
sexuality of the prude. 

Nevertheless that two people brought up 
entirely differently, and having different atti- 
tudes tow T ards love and life, should come into 
sharp conflict is to be expected. Further, 
that disillusionment follows after the excite- 
ment and heightened expectation of courtship 
is inevitable. Marriage at the best includes 
a settlement to routine ; it carries with it an 
adjustment to reality, a getting down to earth 
that is painful and disappointing to minds fed 
to expect thrill and passion with each moment. 

The idealization of the mate — the man or 
woman — gives way to a gradually increasing 
knowledge of imperfection and common clay. 
Common sense, earnestness of purpose, will- 
ingness to adjust, and a sense of humor save 
the situation and change the love of the 
engaged period into a more solid, robust 
affection which gains in durability and wear- 
ing quality what it loses in intensity. 

Unfortunately, in many cases to a great 
extent and in all to some extent, there arises 
dissension natural wherever two human beings 
meet on anything like equal terms. 



In times past (and in many countries at 
the present time), the patriarchal household 
prevailed. The Head of the House was the 
father, a sovereign either stern or indulgent 
according to his nature. Perhaps his wife 
ruled him through his love for her, as w omeii 
Jjave ruled from the beginning of things, but 
if she did it was not by right but by privilege., 

America has changed all that, so say all 
native and foreign observers. Here the 
woman rules; here she drags her husband 
after her like a tail to a kite; here she is 
mistress and he obeys, though nominally still 
head of the household. All the humorists 
emphasize this, and the novelist depicts it as 
the common situation. The husband is rep- 
resented as yoked to the wheel of his wife's 
whims, tyrannized over by the one he works 

This is surely a gross exaggeration, though 
it furnishes excellent material for satire. 
The man still makes the main conditions of 
life for both; his name is taken, his work 
sustains the household, his purse supplies 
the means of existence, his industrial business 
situation determines the residence, his social 
standing is theirs. This does not prevent 


him from being " henpecked' ' in many cases, 
but on the whole it assures his superior 

Nevertheless it is true that the American 
woman of whatever origin has a will of her 
own as no other woman has. Since the ex- 
pression of will is one of the chief sources of 
human pleasures, one of the chief, most 
persistent activities, man and wife enter into 
a contest for supremacy in the household. 
It may be settled quietly and without even 
recognizing its existence, on the common 
plan that the woman shall have charge of the 
home and the man of his business; it may 
rage with violence over the fundamental as 
well as the trivial things of home. After all, 
it is not the importance of a thing that 
determines the size of the row it may raise ; 
men have killed each other over a nickel be- 
cause defeat over even this trifle was in- 

What are the chief sources of conflict? 
For to name them all would be simply to 
name every possible source of difference of 
opinion that exists. Let us take as an 
example Extravagance. 

This is a new development. In the former 


days the bulk of purchases was made by 
the husband, in whose hands the purse 
strings were tightly clutched. With the 
growth of the cities and industry, the develop- 
ment of the department store and rise of shop- 
ping as an institution, the man gave place to 
his wife largely because industry would not 
let him off during the daytime. So the house- 
wife disbursed most of the funds of her home, 
— and there arose one of the fiercest and 
most persistent of domestic conflicts. 

Despite the fact that most American hus- 
bands turn over their purses to their wives, 
they still regard the money as their own. 
The desire to "get ahead" is an insistent one, 
returning with redoubled force after each 
expenditure. He finds his entire income gone 
each week or month, or finds less left than 
he expected. "Where does it all go?" is 
his cry ; " Must we spend as much as we do ? " 
"How do people get along who get less than 
we do?" 

To this his wife has the answer, "We must 
have this, and we must have that. We must 
live as our neighbors do." 

Here is the keynote to the situation. 
There has been a democratization of society 


of this nature; there has been a spread 
throughout the community of aristocratic 
tastes. The woman of even the poor and the 
middle classes must have her spring and 
autumn suits, her dresses for summer, her 
summer and winter hats. Her husband too 
must change his clothes with each shift of 
the season. For this the enterprise of the 
clothing trade, the splendid display of the 
department stores are responsible, awakening 
desire and dissatisfaction. 

"While the man accuses the woman of 
extravagance, he is as guilty as she. He 
too spends money freely, — on his cigars 
and cigarettes, on every edition of the news- 
papers, on the shine which he might easily 
apply himself, on a thousand and one nickels 
that become a muckle. The American is 
lavish, hates to stint, detests being a "piker", 
says, "Oh, what ? s the difference; it will all 
be the same in a hundred years," but kicks 
himself mentally afterwards. 

Meanwhile he quarrels with his wife, who 
really is extravagant. In this battle the 
man wins, even if he loses, for lie rarely 
broods over the defeat. But it brings about 
a sense of tension in his wife ; it brings about 


a disunion in her heart, because she wants to 
please her husband, and at the same time she 
wants to "keep up" with her neighbors and 
friends. And who sets the pace for her, for 
all of her group ; who establishes the standard 
of expenditure? Not the thrifty, saving 
woman, not the one who mends her clothes 
and makes her own hats, but the extravagant 
woman, the rich woman perhaps of recently 
acquired wealth who cares little for a dollar. 
Against her better judgment the woman of 
the house enters a race with no ending and 
becomes intensely dissatisfied, while her hus- 
band becomes desperate over the bills. 

This disunion in her spirit does what all 
such disunions do, — it predisposes her to a 
breakdown. It makes the housework harder ; 
it makes the relations with her husband more 
difficult. It takes away pleasure and leaves 
discontent and doubt, — the mother-stuff of 

While most American husbands are gener- 
ous, there are enough stingy ones to set off 
their neighbors. To these men the goal of 
life is the accumulation of money, as indeed it 
is with the majority. But to them that goal 
is to be reached by saving every penny, by 


denying themselves and theirs all expenditures 
beyond the necessities. 

The woman who marries such a man is 
humiliated to the quick by his attitude. That 
a man values a dollar more than he does her 
wish is an insult to the sensitive woman. 
There ensues either a never-ending battle 
with estrangement, or else a beaten woman 
(for the stingy are stubborn) accepts her 
lot with a broken spirit, sad and deenergized. 
Or perhaps, it should be added, a third result 
may come about ; the woman accepts the 
man's ideal of life and joins with him in their 
scrimping campaign. With this agreement 
life goes on happily enough. 

It is not of course meant that all or a great 
majority of American women have difficulties 
with their husbands over money. But I 
have in mind several patients who would be 
happy if this never-ending problem were 
settled. The struggle "gets on the nerves" 
of the partners ; they say things they regret 
and act with an impatience that has its root 
in fatigue. 

This difficulty over money and its spending 
gets worse in the late thirties and early 
forties, for it is then the man realizes with a 


startled spirit that he is getting into middle 
age, that sickness and death are taking their 
toll of his friends, and that he has not got 
on. The sense of failure irritates him, de- 
presses him. He finds that he and his wife 
look at the money situation from a different 

i "If you loved me," says she, "y° u would see 
things a little more my way." 

"If you loved me," says he, "y° u would not 
act to worry me so." 

Here in the year 1920, the high cost of 
living is becoming the strain of life. Capital 
and Labor are at each other's throats; men 
cry "profiteer" at those whom good fortune 
and callous conscience have allowed to take 
advantage of the world crisis. The air is filled 
with the whispers that a crash is coming, 
though the theaters are crowded, the auto- 
mobile manufacturers are burdened with 
orders, and the shops brazenly display the 
most gorgeous and extravagant gowns. That 
the marital happiness of the country is 
threatened by this I do not see recorded in 
any of the discussions on the subject. Yet 
this phase of the high cost of living is perhaps 
its most important result. 


The housewife's money difficulties are not 
confined to the question of expenditure. 
For there is a factor not consciously put for- 
ward but evident upon a little probing. 

If a woman remains poor, either actually or 
relatively, she always knows some man with 
whom she was familiar in her youth who be- 
came rich, or she has a woman friend whose 
husband has become successful. A subtle 
sort of regret for her marriage may and does 
arise in many a woman, a subtle disrespect 
for her husband because of his failure. The 
husband becomes aware of her decreased 
admiration, and he is hurt in his tenderest 
place, his pride. One of the worst cases of 
neurasthenia I have seen in a housewife 
arose in such a woman, who struggled between 
loyalty and contempt until exhausted. For 
she came of a successful family, she had 
married against their counsel and her hus- 
band, though good, was an entire failure 
financially. Measuring men by their success, 
she found her lowered position almost un- 
endurable but was too proud to acknowledge 
her error. Out of this division in feelings 
came a complete deenergization. 

Whether or not such a housewife deserves 


any sympathy in her trouble, it is certain 
she presents a problem to every one connected 
with her. 

While money and expenditure afford a 
fertile field from which nervousness arises, 
there are others of importance. 

Disagreement and disunion, conflict, arise 
over the training and care of the children. 
Here the different reactions of a man and 
woman — e.g. to a boy's pranks — causes a 
taking of sides that is disastrous to the 
peace of the family. Usually the American 
father believes his wife is too fussy about 
his son's manners and derelictions, secretly 
or otherwise he is quite pleased when his 
son develops into a "regular" boy, — tough, 
mischievous, and aggressive. But sometimes 
it is the overstern father who arouses the 
mother's concern for the child. If a frank 
quarrel results, no definite neurotic symptoms 
follow. It is when the woman fears to side 
against the husband and watches the dis- 
cipline with vexation and inner agony that 
she lowers her energy in the way repeatedly 

Next perhaps to actual disloyalty women 
feel most the cessation of the attentions, 


courtesies, and remembrances of their un- 
married life. Women expect this to happen 
and usually they forgive it in the man who 
devotes himself to his family, struggles for a 
livelihood or better, and helps in the care of 
the children. It is the hyperaesthetic type of 
housewife spoken of previously who weighs 
against her husband's devotion a minor dere- 
liction in courtesy. 

For it is too common in women to let a 
momentary neglect or absent-minded dis- 
courtesy outweigh a lifetime of devotion. 
This is part of a feminine devotion to manner 
and form, of which men are, comparatively 
speaking, innocent. 

Aside from this phase of woman's char- 
acter there are men who either rapidly or 
gradually resume after marriage their bach- 
elor freedom, to the neglect of their wives. 
Though for some time after marriage they 
give up their "freedom" to play consort and 
escort, sooner or later they sink back into 
finding their recreation with their male friends, 
— at club, lodge, saloon, pool room, etc. 
When night comes they are restless. At 
first one excuse or another takes them out, 
later they break boldly from the domestic 


ties and only occasionally and under protest 
do they stay at home or escort the housewife 
to church, visiting, or the theater. 

(It needs be said at this point that in 
America married life often proceeds too far 
in the domestication of the man, in his com- 
plete separation from male companionship, 
in a never-broken companionship between 
man and wife. This is distinctly unhealthy 
for the man, for he requires in his recreation 
the sense of freedom from restraint that he 
can have only in masculine company ; where 
the difficult attitude of chivalry can be dis- 
carded for an equality and a frankness im- 
possible even with his wife.) 

The housewife, thus left alone, though 
wounded, may adjust herself. She may build 
up a companionship for herself in church or 
amongst her neighbors; she may leave her 
husband and get a divorce ; she may become 
unfaithful on the basis that turn about is 
fair play ; she may devote herself with greater 
zeal to her home and children and build up a 
serene life against odds. 

But often she does none of these things. 
Hurt in her pride, she struggles to gain back 
her husband. Tears and reproaches fail, 


sickness sometimes succeeds. If she is child- 
less she becomes obsessed with the belief 
that a child would hold her husband home. 
If she is failing in the freshness of her beauty 
she makes a pathetic effort to hold her in- 
different mate through cosmetics and beauty 
specialists. Without the courage and char- 
acter to make or break the situation she falls 
into a feeling of inferiority from which 
originates her headaches, her feelings of un- 
reality, her loss of enthusiasm, her depressed 
mind and body. 

This type of woman, dependent upon the 
love and affection of her husband for her 
health and strength, mental and physical, is 
the type that woman's education and train- 
ing, at least in the past, have tended to 
make. She has not been taught, she has not 
the power, to stand in life alone; she is the 
clinging vine to the man's oak, she is the 
traditional woman. She is happy and well 
with the right man, but Heaven help her if 
the marriage ceremony links her with a phil- 
anderer ! For she has been taught to accept 
as true and right that mischievous couplet : 

Love is of man's life a thing apart, 
'T is woman's whole existence. 


We need for our womanhood a braver 
standpoint than that, one more firmly based, 
less apt to bring failure and disaster. For 
neither man nor woman should love be the 
whole existence. It should be a fundamental 
purpose interwoven with other purposes. 

Fortunately one source of domestic diffi- 
culty will soon pass from America, — alco- 
holism. Politicians and theorizers may speak 
of the blow to individual liberty and satirically 
prophesy that soon coffee and tobacco will be 
legislated out also. They need to read Gil- 
bert Chesterton and learn that though "a 
tree grows upward it stops growing and never 
reaches the sky." To see, as I do, the almost 
complete absence of delirium tremens from 
the emergency and city hospitals, where once 
every Sunday morning found a dozen or two of 
raving men ; to witness the disappearance of 
alcoholic insanity from our asylums, where 
once it constituted fifteen per cent of the 
male admissions ; to see cruelty to children 
drop to one tenth of its former incidence ; 
to know that former drunkards are steadily 
at work to the joy of their wives and the good 
of their own souls, — this is to make one 
bitterly impatient with the chatter about the 


"joy and pleasure of life gone," etc. etc., that 
has become the stock-in-trade of the stage 
and the press. Though alcoholism did not 
cause all poverty, it stupefied men's minds so 
that they permitted much preventable pov- 
erty ; though it did not cause all immoral- 
ity, a few drinks often sent a good man to the 
brothel; and what is more, many of the 
brothel inmates endured their life largely be- 
cause of the stupefying use of alcohol. 

No one knows the evil of alcohol more than 
the poor housewife. Of course the woman 
brought up to believe that drunkenness was 
to be expected in a man — and who often 
drank with him — was a victim without 
severe mental anguish, though her whole life 
was ruined by drink. But for the refined 
woman who married a clean, clever young 
fellow only to have him come home some 
day reeking of liquor, — silly, obscene, help- 
less, — her contact with John Barleycorn took 
the joy and sweetness from her life. She 
often adjusted herself, but in many cases 
adjustment failed, and a chronic state of 
bruised and tingling nervousness resulted. 

A future generation will not consider it 
possible that the people of a century that 


saw the use of wireless, the airship, radium, 
and the X-ray could think intoxication with 
its literal poisoning funny, could make a stock 
humorous situation out of it, and could regard 
the habit-forming drug that caused it a 

After all is said and done, the fiercest 
domestic conflicts arise out of the inherent 
childishness of men and women. Pride and 
the unwillingness to concede personal error, 
overtender egoism, bossiness, and rebellion 
against it, petty jealousies and stubbornness, 
— these are the basic elements in discord. 
Children quarrel about trifles, children are un- 
reasonably jealous, children fight for leader- 
ship and seek constantly to enlarge their ego 
as against their comrades. Any one who 
watches two five-year-olds for an hour will 
observe a dozen conflicts. So with many 
husbands and wives. 

Unreason, petty jealousy, stubbornness over 
trifles, bossiness (not leadership), overready 
temper and overready tears, — these cause 
more domestic difficulty than alcohol and 
unfaithfulness put together. The education 
of American women is certainly not tending 
to eradicate these defects, which are not 


necessarily feminine, from her character. In 
the domestic struggle the man has the major 
faults as his burden ; the woman has a host 
of minor ones. She claims equality for her 
virtues yet demands a tender consideration 
for her weaknesses. 

Dealing with petty annoyances, disagreeing 
over petty matters, with her mind engrossed 
in her disillusions and grievances, many a 
woman finds her disagreeables a burden too 
much for her "nerves." That a philosophy 
of life would save her is of course obvious, 
but this is a matter which we shall deal with 


The Symptoms as Weapons against the 

Throughout life, two great trends may be 
picked out of the intricacy of human motives 
and conduct. The one is (or may be called) 
the Will to Power, the other the Will to 
Fellowship. The will to power is the desire 
to conquer the environment, to lead one's 
fellows, to accumulate wealth (power), to 
write a great book (influence or power), to 
become a religious leader (power), to be 
successful in any department of human effort. 
In every group, from a few tots playing in the 
grass to gray-headed statesmen deciding a 
world's destinies, there is a struggle of these 
wills to power. In the children's group this 
takes the trivial (to us) form as to who 
shall be "policeman" or "teacher", in the 
statesmen it takes the "weighty" form as to 
which river shall form a boundary line and 


which group of capitalists shall exploit this 
or that benighted country. The will to power 
includes all trends which innate the ego, — love 
of admiration, pride, reluctance to admit 
error, desire for beauty, lust for possession, 
cruelty, even philanthropy, which in many 
cases is the good man's desire for power over 
the lives of his fellows. 

Side by side with this group of instincts and 
purposes, interplaying and interweaving with 
it, modifying it and being modified by it, is the 
group we call the will to fellowship. This is 
the social sense, the need of other's good will, 
the desire to help, sympathy, love, friendly 
feeling, self-sacrifice, sense of fair play, all 
the impulses that are essentially maternal 
and paternal, devotion to the interests of 
others. This will to fellowship permeates 
all groups, little and big, old and young, 
and is the cement stuff of life, holding society 

There are those who find no difference 
between the egoism of the will to power and 
the altruism of the will to fellowship. They 
assert that if egoism is given a wider range, 
so that the ego includes others, you have 
altruism, which therefore is only an egoism 


of a larger ego. However true this may be 
logically, for all practical purposes we may 
separate these two trends in human nature. 

In each individual there goes on from cradle 
to grave a struggle between the will to 
power and the will to fellowship. The teach- 
ing of morality is largely the government, 
the subordination of the will to power; the 
teaching of success and achievement is largely 
the discovery of means by which it is to be 
gained. However we may disguise it to our- 
selves, power is what we mainly seek, though 
we may call our goal knowledge, science, 
benevolence, invention, government, money. 

Without the will to fellowship the will to 
power is tyranny, harshness, cruelty, autoc- 
racy, and men hate the possessor of such a 
character. Without the will to power, the 
will to fellowship is sterile, futile, and the 
owner becomes lost in a world of striving 
people who brush him aside. The two must 
mingle. And a curious thing becomes evi- 
dent in the life of men, which in itself is 
simple enough to understand. When men 
who have been ruthless, concentrated on 
success, specialists in the will to power, 
reach their goal, they often turn to the 


thwarted will to fellowship for real satis- 
faction in life, become philanthropists, world 
benefactors, etc. On the other hand those 
who start out with ideals of altruism and 
service, specialists in the will to fellowship, 
generally lose enthusiasm for this and turn 
slowly, half reluctantly, to the will for power. 
In life's cycle it is common to see the egotist 
turn philanthropist, and the altruist, the 
idealist, lose faith and become an egotist. 

How does this apply to the nervous house- 
wife? Simply this, that there are various 
ways of seeking power, of gaining one's 

There is first the method of force, directly 
applied. The strong man disdains subtlety, 
persuasion, sweeps opposition aside. "Might 
is right" is his motto; he beats down oppo- 
sition by fist, by sword, by thundering voice, 
or look. Men who use this method are 
little troubled by codes; they follow the 
primitive line of direct attack. j 

There is second the method of strategy, 
the disguise of purpose, the disguise of means. 
The effort is to shift the attention of the 
opponent to another place and then to walk 
off with the prize. "Possession is nine points 


of the law" say these folk. And a straight 
line is not the shortest way for strategy. 
Or exchange with your opponent, give what 
seems valuable for what is valuable and then 
fall back on the adage, "A fair exchange is 
no robbery." 

Third, there is persuasion. Here, by 
stirring your opponent into friendliness, he 
talks matters over, he aligns his interest 
with yours. Compromise is the keynote, 
cooperation the watchword. " 'T is folly to 
fight, we both lose by battle; whose is the 

Fourth is the method of the weak, to gain 
an end through weakness, through arousing 
sympathy, by parading grief, by awakening 
the discomfort of unpleasant emotion in 
an opponent who is of course not an im- 
placable enemy. This has been woman's 
weapon from time immemorial; tears and 
sobs are her sword and gun. Unable to cope 
with man on an equal plane, through his 
superior physical strength, his intrenched 
social and legal position, she took advantage 
of her beauty and desirability, of his love; 
if that failed, she fell back on her grief and 
sorrow by which to plague him into sub- 


mission, into yielding. Children use this 
weapon constantly ; they cry for a thing and 
develop symptoms in the face of some dis- 
agreeable event, such as a threatened punish- 
ment. In their day-dreams the idea of dying 
to punish their cruel parents is a favorite one. 

This appeal to the conscience of the stronger 
through a demonstration of weakness may be 
called "Will to Power through Weakness." 
It has long been known to women that a man 
is usually helpless in the presence of woman's 
tears, if it is apparent that something he has 
done has brought about the deluge. And in 
the case of some housewives, certain similar- 
ities between tears and the symptoms appear 
that show that in these cases, at least, the 
symptoms of nervousness appear as a sub- 
stitute for tears in the marital conflict. 

Not that 'this is a deliberate and fully 
conscious process, nor that it causes the 
symptoms. On the contrary, it is a use for 
them ! 

Such a conclusion of course is not to be 
reached in those cases where the symptoms 
arise out of sickness of some kind, or where 
they follow long and arduous household 
tasks. But every one knows that the woman 


who gets sick, has a nervous headache, weak- 
ness, a loss of appetite, or becomes blue as 
soon as she loses in some domestic argument, 
or when her will is crossed ; these symptoms 
persist until the exasperated but helpless 
husband yields the point at issue. Then 
recovery takes place almost at once. 

In some of the severer cases of neurasthenia 
in women such a mechanism can be traced. 
There is a definite relation between the onset 
of the attacks and some domestic difficulty, 
and though the recovery does not take place 
at once, an adjustment in favor of the wife 
causes the condition to turn soon for the 

I do not claim that the above is an original 
discovery. True, the medical men have not 
formulated it in their textbooks, but every 
experienced practitioner knows it to occur. 
And the humorists and the satirists of the 
daily press use the theme every day. The 
favorite point is that the brutal husband is 
forced to his knees through the disabilities 
of his wife, and that cure takes place when — 
he gets her the bonnet or dress she wants, 
when the trip to Florida is ordered, etc. etc. 

Discreditable to women ? Discreditable to 


those women who use it? Men would do 
the same in the face of superior force. In the 
battle of wills that goes on in life the weak 
must use different weapons than the strong. 
Doubtless the women of another day, trained 
otherwise than our present-day women and 
having a different relationship to men, will 
abandon, at least in larger part, the weapons 
of weakness. Wherever women work with 
men on a plane of equality they ask no favors 
and resort to no tears. They play the game 
as men do, as "good sports." But where 
the relationship is the one-sided affair of 
matrimony, a certain type uses her tears, her 
aches and pains, her moods, and her failings 
to gain her point. 


Histories of Some Severe Cases 

The cases that follow represent mainly the 
severe types of nervousness in the house- 
wife. To every case that comes to the neurol- 
ogist there are a hundred that explain their 
symptoms as "stomach trouble", "back- 
ache", etc., who remain well enough to 
carry on, and who think their pains and aches 
inevitably wrapped with the lot of woman. 

It will be seen, upon reading these cases, 
that a rather pessimistic attitude is taken 
toward some of them. It would be nice to 
present a series of cases all of which re- 
covered, and it would be easy to do that by 
picking the cases. Such a series would be 
optimistic in its trend; it would however 
have the small demerit of being false to life. 
Though the majority of women suffering 
from nervousness may be relieved or cured, 
a number cannot be essentially benefited. 


Some of them have temperaments utterly 
incompatible with matrimony, others have 
husbands of the incorrigible type, others have 
life situations to change which would make 
it necessary to change society. Therefore 
in these cases all a doctor can do is to relieve 
symptoms, relieve some of the distress and 
rest content with that. 

I am essentially neither pessimist nor 
optimist in the presentation of these cases, 
nor do I seek to present the man or woman's 
case with prejudice. In life a realistic attitude 
is the best, for if we were to remove much of 
the sentimental self-deception at present so 
prevalent, huge reforms would occur almost 
overnight. Sentimentality decorates and dis- 
guises all kinds of horridness and makes us 
feel kindly toward evil. Strip it away, and 
we would immediately break down the evil. 

There is always this danger in presenting 
"cases" to a lay public, that symptoms are 
suggested to a great many people. How 
deeply suggestible the mass of people can be 
is only appreciated when one sees the result 
of public health lectures and books. Many 
persons tend to develop all the symptoms 
they hear of, from pains and aches to mental 


failure. Even in the medical schools this is 
so, and every medical teacher is consulted 
each year by students who feel sure they have 
the diseases he has described. 

So in presenting the following cases symp- 
toms will be largely omitted. What will be 
presented is history and to a certain extent 
treatment. That part of treatment which is 
strictly medical can only be indicated. 

It may be said that in obtaining the inti- 
mate history of a woman a difficulty is met 
with in the natural reluctance to telling what 
often seems to the patient painful and un- 
necessary details. To some people it seems 
inconceivable that fears, pains and aches, 
sleeplessness, etc., can arise out of difficulties 
like the monotony of housework, tempera- 
ment, or troubles with the husband. Further- 
more, though some women understand well 
enough the source of their conflicts, they are 
ashamed to tell and rest mainly on the surface 
of their symptoms. To obtain the truth it is 
necessary to see the patient over and over 
again, to get somewhat closer to her. This is 
especially easy to do after the physician has 
to a certain extent relieved the patient. 
In other words, except in the cases where the 


woman is quite prepared to tell of her inti- 
mate difficulties, it is best to go slowly from 
the medical to the social-psychological point 
of view. 

Case I. The overworked, under-rested type 
of housewife. 

Mrs. A. J., thirty years old, is a woman of 
American birth and ancestry. Her parents 
were poor, her father being a mechanic in a 
factory town of Massachusetts. She had 
several brothers and sisters, all of whom 
reached maturity and most of whom married. 
Before marriage she was a salesgirl in a 
department store, worked fairly hard for 
rather small pay, but was strong, jolly, liked 
dancing and amusements, liked men and had 
her girl friends. 

At the age of twenty-two she married a 
mechanic of twenty-four, a good, sober, 
steady man, devoted to her and very domestic. 
Unfortunately he was not very well for some 
time following a pneumonia in the third 
year of their marriage. They drew upon all 
their savings and fell seriously in debt. This 
meant borrowing and scrimping for several 
years, — a fact which had great bearing on 
the wife's illness later. 


They had three children, born the twelfth 
month, the third year, and the fourth year 
after marriage. After the first child the 
mother was very well, nursed the baby success- 
fully, and the little family flourished. Then 
came the unfortunate illness of the husband, 
which threw him out of work for six months, 
during which time they lived on an allow- 
ance from his union, his savings, and finally 
ran into debt. This greatly grieved the man 
and depressed the woman, but both bore 
up well under it until the birth of the second 
child, when their circumstances forced them 
to move to a poorer apartment. The wife 
was delivered by a dispensary physician, 
who did his duty well but allowed the woman, 
who protested she felt well, to get up and care 
for her husband and baby much earlier than 
she should have done. 

The nursing of this baby was more difficult. 
The mother's breasts did not seem to be 
nearly as active as in the previous case. The 
baby cried a great deal and needed attention 
a good part of the night. The husband was 
unable to help as he had previously done and 
the fatigue of the care of child and man 
brought a condition where the woman was 


tired all the time. Still she bore up well, 
though when the summer came she greatly 
missed the little two weeks' vacation that 
she and her husband had yearly taken to- 
gether from the days of their courtship. 

The husband recovered, but his strength 
came back very slowly. He went to work as 
soon as possible but worked only part time 
for six months. At night he came home 
utterly exhausted and could not help his 
wife at all. 

During the next year both children were 
sick, first with scarlet fever and then with 
whooping cough. The mother did most of the 
nursing, though by this time the father was 
able to help and did. The necessary ex- 
penses so depleted the family treasury that 
when the summer came neither could afford 
to go away. 

Both noticed that the mother was getting 
more irritable than was natural to her. She 
went out very seldom and her youthful good 
looks had largely been replaced by a sharp- 
featured anxiety. Though she carried on 
faithfully she had to rest frequently and 
at night tossed restlessly, though greatly 


She became pregnant again, much to her 
dismay and to the great regret of her hus- 
band. At times she thought of abortion, 
but only in a desperate way. The last few- 
months of her term were in the very hot 
months of the year and she was very un- 
comfortable. However, she was delivered 
safely, got up in a week to help in the care 
of her other two children and to get the 
house into shape again. Her milk was fairly 
plentiful, despite her fatigue and "jumpy 
nerves." Unfortunately at this time, when 
they had accumulated a little surplus and 
she was looking forward to better clothes for 
her family and more comforts, the plant at 
which her husband was employed suspended 
operations because of some "high finance" 
mix-up. Coming at this time, the news 
struck terror into her heart ; she broke down, 
became "hysterical", i.e. had an emotional 
outburst. This passed away, but now she 
was sleepless, had no appetite, complained of 
headache and great fatigue. 

Though she was assured that the plant 
would reopen soon (in fact it soon did), 
she made little progress. That she was 
suffering from a psychoneurosis was evident ; 


what remained was to bring about treat- 

This was done by enlisting a development 
of recent days, — the Social Service agencies. 
Out of the old-time charity has come a fine 
successor, social service ; out of the ama- 
teurish, self-consciously gracious and sweet 
Lady Bountiful has come the social worker. 
Unfortunately social service has not yet 
dropped the name "Charity", perhaps has 
not been able to do so, largely because the 
well-to-do from wdiom the money must come 
like to think of themselves as charitable, 
rather than as the beneficiaries of the social 
system giving to the unfortunates of that 

Let me say one more word about social 
service and the social worker, though I feel 
that a volume of praise would be more fitting. 
The social worker has become an indispensable 
part of the hospital organization, an inves- 
tigator to bring in facts, a social adjuster to 
bring about cure. For a hospital to be 
without a social service department is to 
confess itself behind the times and in- 

Briefly, this is what was done for this family. 


Their prejudices against social aid were re- 
moved by emphasizing that they were not 
recipients of charity. The husband was 
allowed to pay, or arrange to pay, for a six 
weeks' stay in the country for the mother 
and the new baby. The home for this purpose 
was found by the agency and was that of a 
kindly elderly couple who took the woman 
into their hearts as well as over their thresh- 
old. The social worker arranged with a 
nursing organization to send a worker to the 
man's house each day to clean up the home 
while the children stayed in a nursery. One 
way or another the husband and children 
w T ere made comfortable, and the wife came 
back from her stay, made over, eager to get 
back to her work. 

It is obvious that in such a case as this the 
physician is largely diagnostician and director, 
the actual treatment consisting in getting a 
selfish and inert social system to help out 
one of its victims. That a sick man should 
be left to sink or swim, though he has pre- 
viously been industrious and a good member 
of society, is injustice and social inefficiency. 
That a woman, under such circumstances, 
should be left with the entire burden on her 


hands is part of the stupidity and cruelty of 

How avert such a thing? For one thing 
do away with the name "Charity" in relief 
work, — and find some system by which 
industry will adequately care for its victims. 
What system will do that? I fear it may be 
called socialistic to suggest that some of the 
fifteen billions spent last year on luxuries 
might better be shifted to social amelioration. 
The record in automobile production would 
be more pleasing if it did not mean a shift 
from real social wealth to individual luxury. 

Case II. The over-rich, purposeless woman. 

This type is of course the direct opposite 
of the woman in Case I and represents the 
kind of woman usually held up as most 
commonly afflicted with "nervousness." "If 
she really had something to do," say the 
critics, "she would not be nervous." 

This is fundamentally true of her, though 
not true of the majority of women whom 
we have discussed. It seems difficult to 
believe that hard work and worry may bring 
the same results as idleness and dissatisfac- 
tion, but it is true that both deenergize the 
organism, the body and mind, and so are 


kindred evils. What's the matter with the 
poor is their poverty, while the matter with 
the rich is their wealth. 

Mrs. A. De L. is of middle-class people 
whose parents lived beyond their means 
and educated their only daughter to do the 
same. Here is one of the anomalies of life : 
bitterly aware of their folly, the extravagant 
and struggling deliberately push their children 
into the same road. Mrs. De L. learned 
early that the chief objects of life in general 
were to keep up appearances and kill time; 
that as a means to success a woman must 
get a rich husband and keep beautiful. 
Being an intelligent girl and pretty she man- 
aged to get the rich husband, — and settled 
down to the rich housewife's neurosis. 

Her husband was old-fashioned despite 
his rather new wealth, and they had two 
children, — a large modern American family. 
Though he allowed her to have servants he 
insisted that she manage their household, 
which she did with rebellion for a short time, 
and then rather quickly broke away from it 
by turning over the household to a house- 
keeper. This brought about the silent 
disapproval of her husband, who let her 


"have her own way", as he said, "because 
it 's the fashion nowadays." 

She became a seeker of pleasure and sen- 
sation, drifting from one type of amusement 
to the other in an intricately mixed co- 
operation and rivalry with members of her 
set. She followed every fad that infests 
staid old Boston, from the esoteric to the 
erotic. She became an accomplished dancer, 
ran her own car, followed the races, went to 
art exhibitions, subscribed to courses of 
lectures of which she would attend the first, 
dabbled in new religions, became enthusiastic: 
about social work for a month or two, — and 
became a professional at bridge. Summers 
she rested by chasing pleasure and flirting 
with male habitues of fashionable summer 
resorts; part of the winter she recuperated 
at Palm Beach, where she vied for the leader- 
ship of her set with her dearest enemy. 

Her husband financed all her ventures with 
a disillusioned shrug of his shoulders. As 
she entered the thirties she became intensely 
dissatisfied with herself and her life, tried to 
get back to active supervision of her home but 
found herself in the way, though her children 
were greatly pleased and her husband seep- 


tical. The need of excitement and change 
persisted ; gradually an intense boredom 
came over her. Her interest in life was dulled 
and she began a mad search for some sen- 
sation that would take away the distressing 
self-reproach and dissatisfaction. Shortly 
after this she lost the power to sleep and had 
a host of symptoms which need not be de- 
tailed here. 

The medical treatment was first to restore 
sleep. I may say that this is a first step of 
great importance, no matter how the sleepless- 
ness originates. For even if an idea or a 
disturbing emotion is its cause, the sleepless- 
ness may become a habit and needs energetic 

With this done, attention was paid to the 
social situation, the life habits. It was 
pointed out that all the philosophies of life 
were based on simple living and work, and 
that all the wise men from the beginning of 
the written word to our own times have 
shown the futility of seeking pleasure. It 
was shown that to be a sensation seeker was 
to court boredom and apathy, and that these 
had deenergized her. 

For interest in the world is the great source 


of energy and the great marshaler of energy. 
From the child bored by lack of playmates, 
who brightens up at the sight of a woolly 
little dog, to the old and vigorous man who 
makes the mistake of resigning from work, 
this function of interest can be shown. 

She was advised to get a fundamental, 
nonegoistic purpose, one that would rally 
both her emotions and her intelligence into 
service. Finally she was told bluntly that 
on these steps depended her health and that 
from now on any breakdown would be merely 
a confession of failure in reasonableness and 

That she improved greatly and came back 
to her normal health I know. Whether she 
continued to remain well and how far she 
followed the advice given I cannot say. 
From the earliest time to this, necessity has 
been the main spur to purpose, and probably 
the lure of social competition drew the lady 
back to her old life. Experience, though 
the best teacher, seems to have the same 
need of repetition that all teaching does. 

Case III. The physically sick woman who 
displays nervousness. 

Though this is one of the most important 


of the types of nervous housewife the subject 
is essentially medical. We shall therefore 
not detail any case, but it is wise to re- 
emphasize some facts. 

There are bodily diseases of which the 
early and predominant symptoms are classed 
as " nervousness. " Hyperthyroidism, or 
Graves' Disease, a condition in which there 
is overactivity of the thyroid gland and 
which is particularly prevalent among young 
women, is one of those diseases. In this 
condition excitability, irritability, emotional 
outbursts, fatigue, restlessness, digestive dis- 
orders, vasomotor disorders, appear before 
the characteristic symptoms do. 

Neuro-syphilis is another such disease. 
This is an involvement of the nervous system 
by syphilis. One of the tragedies that dis- 
tresses even hardened doctors is to find some 
fine woman who has acquired neuro-syphilis 
through her husband, though he himself may 
remain well. In the early stages this disease 
not only has neurasthenic symptoms but is 
very responsive to treatment, and thus the 
early diagnosis is of great importance. 

WTiat is known as reflex nervousness arises 
as a result of minor local conditions, such as 


astigmatism and other eye conditions, trouble 
with the nose and throat and trouble with 
the organs of generation. The latter is 
especially important in any consideration of 
nervousness in the housewife, particularly in 
the woman who has borne children. Fre- 
quently too the existence of hemorrhoids, re- 
sulting from constipation, acts to increase the 
irritability of a woman who is perhaps too 
modest to consult a physician regarding such 
trouble. Where such modesty exists (and it 
is found in the very women one would be apt 
to think were the very last to be swayed by 
it), then a competent woman physician should 
be consulted. With good women physicians 
and surgeons in every large community there 
is no reason for reluctance to be examined on 
the part of any woman. 

Further details are not necessary. Enough 
has been said to emphasize the fact that the 
nervousness of the housewife is first a medical 
problem and then a social-psychological one. 

Case IV. A case presenting bad hygiene as 
the essential factor. 

Bad hygiene is something more than ex- 
posure to bad air, poor food, contaminated 
water, etc. It includes habits and times of 


eating, attention to the bowels, outdoor 
exercise, sleep, and in the marital state it 
includes the sexual indulgence. 

The housewife under consideration, Mrs. 
T. F., aged twenty-eight, married five years, 
two children, complained mainly of headache, 
occasional dizziness, great irritability, and 
fatigue, so that quarrels with her husband 
were very common, though there seemed 
nothing to quarrel about. The family was 
not rich, but lived in a comfortable apart- 
ment ; there were no serious financial burdens, 
the children were reasonably healthy and 
good, and the closest questioning revealed 
the husband as a kindly man who never took 
the initiative in quarrels but who was never 
able to keep silent under provocation. The 
couple was still in love and there seemed to be 
no essential incompatibility. 

Questioned as to her habits, Mrs. F. said 
she did all her own housework except the 
washing and ironing and scrubbing. She 
had a little girl three times a week to take 
the baby out. Before marriage she had been 
a stenographer, but never earned high pay 
and had no love for her work. In fact she 
gave it up with relief and found housework 


with its disagreeable features much more 
to her taste than business. She had been of a 
placid, pleasant temperament and could not 
understand the change in her. 

Since all this did not explain her symptoms, 
closer inquiry was made into her habits. 
She arose with her husband at seven-thirty, 
prepared his breakfast, sent the oldest child 
off to kindergarten and then had her own 
breakfast, which usually consisted of toast 
and coffee. At noon she had a very small 
piece of meat or an egg and a few potatoes 
with tea. At night she ate sparingly of the 
dinner, which usually was meat, potatoes, 
another vegetable, and a dessert. Her hus- 
band here stated that she ate at this meal less 
than the boy of four and a half. 

Comparing her buxom figure with the diet a 
discrepancy was at once apparent. She then 
confessed with shame that she was a constant 
nibbler, eating a bit of this or that every half 
hour or so, and consequently never had an 
appetite. The food thus nibbled usually was 
either spicy or sweet, and she consumed quite 
a bit of candy. Her bowels moved infre- 
quently and she always needed laxatives. 
In her spare time she felt rather "logy", 


rarely went out, except now and then at 
night with her husband, and spent her leisure 
hours on the couch reading or nibbling. 

This in itself would have quite explained 
much of her trouble. It has been pointed 
out that body and mind are not separable; 
that mental functions are based on the bodily 
functions, and that mood may rest on no 
more exalted cause then the condition of 
the bowels. But a more intimate questioning 
revealed sexual habits which are easily drifted 
into by people of an amorous turn of char- 
acter and who are really fond of one another. 
These both husband and wife frankly said 
they had not meant to speak of, but with their 
disclosure it was evident that a good deal of 
importance was to be attached to them. 

The correction of the life habits was of 
course the fundamental need. The young 
woman was instructed in detail as to diet, 
the care of the bowels and outdoor exercise. 
Since she was in perfect condition except for 
stoutness she could easily look for recovery, 
and as an added incentive the restoration of 
youthful good looks was held out as certain. 

The sexual life was frankly discussed, and 
necessary restrictions were imposed. Both 


the husband and wife agreed willingly to the 
changes ordered and promised faithfully to 
carry out instructions. 

The patient made a splendid recovery and 
very rapidly. Here was a deenergization 
dependent solely upon the sedentary life 
of the housewife and upon ignorance of sex 
hygiene. Here were quarreling and impend- 
ing marital disaster removed by attention 
to details in living. Here was a complete 
proof that not only does a sound mind need a 
sound body, but that a sound marriage needs 
one as well. 

Case V. The hypersesthetic woman. 

Mrs. J. F. is twenty-seven years of age. 
She was born in the United States, of middling 
well-to-do people. Her father was a gruff, 
hearty man, not in the least bit finicky, 
who really despised manners and the like, 
though he was conventional enough in his 
own way. Her mother was an old-fashioned 
housewife, fond of her home and family, 
in fact perhaps more attached to the former 
than the latter. She hated servants and got 
along without them (except for a day woman) 
until she became rather too old to do the 


J.'s sister and two brothers were duplicates 
of the parents, — hearty, stolid, and remark- 
ably plain looking. J., the younger sister, 
though not the youngest in the family, was 
as different from her family as if she had 
sprung from another stock. She was slender, 
very pretty, with a quick, alert mind which 
jumped at conclusions, because labored analy- 
sis fatigued it. Above all, from the very 
start of life she was sensitive to a degree that 
perplexed her family, who were however 
intensely sympathetic because they adored 
her. This adoration arose from the fact that 
J. was brighter and prettier than most of her 
friends, and that her cleverness in many 
directions — music, writing, talking, handi- 
work — was the talk of their little group. 

This sensitiveness arose from two main 
factors. First, an egoism fostered by the 
worship of her friends and the leadership of 
her group, — an egoism which led her to re- 
gard as a sort of insult anything disagreeable. 
Accustomed to praise, the least criticism im- 
plied or outspoken cut like a knife; ac- 
customed to being waited upon, she re- 
sented physical discomfort of the slightest 
kind. Second, there must also have been an 


actual physical sensitiveness to sights, sounds, 
smells, tastes, etc. that made her perceive what 
others failed to notice. This led to an artistry 
manifested by her nice work in music and 
decoration and also by an excessive dis- 
pleasure at the inartistic. 

With this training, experience, and natural 
temperament she should have married a rich 
collector of art products, who would have 
added her to his collection and cherished her 
as his most fragile possession. Instead, 
through the working of that strange law of 
contraries by which Nature strikes averages 
between extremes, she fell in love with a hulk 
of a man whose ideas on art were limited to 
calling a picture "pretty", who loved sports 
and the pleasures of the table, and whose 
business motto was "Beat the other guy to 
it." A successful man, troubled with few 
subtleties either of approach or conscience, 
he viewed the marriage relationship in the 
old-fashioned way and the new American 
indulgence. A man's wife was to be given 
all the clothes she wanted, servants to help 
run the home, ought to bear two or three 
children, and love her indulgent husband. 
As for any real intimacy, he knew nothing 


of it. Kindly, self-indulgent, wifr -indulgent, 
child-indulgent, ruthless in business, he may- 
stand as something America has produced 
without any effort. 

From the very first night J.'s world was 
shattered. We need not enter into details 
in this matter, but a woman of this type needs 
finesse in the initiation into marriage more 
than at any other time. Cave-man style 
outraged her every fiber, and the man was 
dumbfounded at her reaction. Though he 
tried to make amends his very effort and 
lack of understanding complicated matters. 

Aside from this matter, which in the course 
of time became adjusted, so that though she 
rebelled desire arose in her, she found herself 
at odds with her husband's tastes and con- 
duct in little things. Though his table 
manners were good enough, the gusto of his 
eating annoyed her and took away her own 
appetite. When they went to a play to- 
gether the coarse jokes and the plainly sen- 
suous aroused his enthusiasm. He lacked 
subtlety and could not understand the 
"finer" things of life. As he grew settled 
in matrimony, which he enjoyed in spite of 
her nerves (which he took for granted as 


like a woman), he grew stouter and this 
irritated and jarred her. 

She finally realized she no longer loved 
him. It is doubtful if she realized this before 
the birth of her first and only child. She 
lacked maternal feeling and rebelled with a 
bitter rebellion against the distortion of her 
figure that came with the pregnancy. The 
nursing ordered by the doctor and expected 
by all around her nearly drove her "wild", 
she said, for she felt like a "cow", a "female." 
Indeed she reacted bitterly against the f emale- 
ness that marriage forced on her and hated the 
essential maleness of her husband. Her emo- 
tional reaction against nursing took away her 
milk, and finally the disgusted family doctor 
ordered the baby weaned and he was turned 
over to a servant. 

She went back to her own life, determined 
to become a housewife, to see if she could not 
love her husband and her home. But every- 
thing he did irritated her, and everything in the 
house made her feel as in a "luxurious cage." 
Yet she was by no means a feminist ; she de- 
tested "noisy suffragettes", thought women 
doctors and lawyers ridiculous, and had been 
brought up to regard marriage as indissoluble. 


Gradually out of the conflict, the chilling 
fear that she had made a mistake which 
could not be rectified, the constant irritation 
and annoyances, the revolt against her own 
sex feeling and her life situation, arose the 
neurosis. It took the form mainly of sudden 
unaccountable fears with faint dizzy feelings. 
The family physician on the aside told me that 
it was "just a case of a damn fool woman 
with everybody too good to her." 

What constitutes a "damn fool" will in- 
clude every person in the world, according to 
some one else. It seemed obvious to me that 
J. was not meant by nature to be a housewife 
or any kind of wife. Matrimonially she 
was a misfit, unless she met some man of a 
type like herself, though I doubt if any man 
could have pleased her. I doubt if her over- 
exacting taste would not rebel against the 
animal in life itself. For though the animal 
of life is essentially as fine as the human, 
certain types find it impossible to acknowl- 
edge it in themselves. 

At any rate I advised separation for a time, 
— six months at least. I told the woman her 
reaction to her husband was abnormal and 
finicky. She answered that she knew this 


but could not conceive of any change. We 
discussed the matter in all its ramifications, 
and though she and her husband agreed to the 
separation, I knew that he was determined 
to hold her to her contract. She improved 
somewhat but I believe that such a tempera- 
ment is incompatible with marriage, at least 
to such a man. The outlook is therefore a 
poor one. 

Case VI. The over-conscientious house- 
wife, — the seeker of perfection. 

The woman whose history is to be dis- 
cussed comes from a family of New England 
stock, i.e. the Anglo-Saxon strain modified 
by New England climate, diet, history, religion, 
and tradition into a distinct type. This type, 
often traditionally conservative and often 
extraordinarily radical, has this prevailing 
trait, — standards of right and wrong are 
set up somehow or other, and a remarkably 
consistent effort is made to maintain these 
inflexibly. However, the hyperconscientious 
are not peculiarly New England alone; I 
have met Jewish women, Italians, French, 
Irish, and Negroes who showed the same 
loyalty to a self-imposed ideal. 

This lady, Mrs. F. B., thirty-five years 


of age, with three children, was brought by 
her husband against her will. He declared 
that both she and he were on the verge of 
nervous prostration; that unless something 
was done he would start beating her, this 
last of course representing a type of humor- 
ous desperation that usually has a wish con- 
cealed in it. She was "worn to a frazzle", 
always tired, sleepless, of capricious appetite, 
irritable, complaining, and yet absolutely re- 
fused to see a physician. She had taken 
tonics by the gallon, been overhauled by a 
dozen specialists, all of whom say, "nothing 
wrong of any importance — yet she is a 
wreck and I am getting to be one." 

Her husband was a jolly looking personage 
from the Middle West, in a small business 
which kept his family comfortably. He 
looked domestic and admitted he was, which 
his wife corroborated. Evidently he was 
exasperated and worried as he gave the his- 
tory of the case, with his wife now and then 
putting in a word: "Now, John, you are 
stretching things there; don't believe him, 
Doctor; not so bad as all that," etc. 

She was a slender person, rather dowdily 
dressed as compared with her husband, with 


garments quite a little behind the prevailing 
mode. Her hair was unbecomingly put up, 
and it was evident that she disdained cos- 
metics of any kind, even the innocent rice 
powder. Her hands were quite unmani- 
cured, though they were, of course, clean and 
neat. The hat was the simplest straw, home 
trimmed and neat, but a mere "lid" compared 
to the creations most women of her class were 
at the time wearing. That clothes were meant 
to be ornamental as well as useful was an at- 
titude she completely rejected. 

It turned out that life to her was an eternal 
housekeeping, — from the beginning of the 
day to the end she was on the job. Though 
she had a maid this did not relieve her much, 
for she constantly fretted and fumed over the 
maid's slackness. Everything had to be 
spotless all the time; she could not bear the 
disordered moments of bedtime, of the early 
morning hours, of wash day, of meal prep- 
aration, of the children's room, etc. She 
was obsessed by cleanliness and order, and 
her exasperated efforts, her reaction to any 
untidiness kept her husband and children 
bound in a fear like her own, though they 
rebelled and scolded her for it. 


"She 's always after the children," said her 
husband. "She is crazy about them, but 
she has got them so they don't dare call their 
soul their own. They don't bring their 
playmates into the house largely because they 
know that mother, though she wants children 
to play, goes after them picking up and 

This restlessness in the presence of disorder 
was accompanied by the effort to eradicate 
all vices, all discourtesies, all errors in manners 
from the children. She feared "bad habits" 
as she feared immorality. She thought that 
any rudeness might grow into a habit, must 
be broken early; any selfish manifestation 
might be the beginning of a gross selfishness, 
any lying or pilfering might be the beginning 
of a career of crime. 

Here one might hold forth on the necessity 
for trial and error in children's lives. They 
want to try things, they form little habits for 
a day, a week, a month which they discard 
after a while ; they try out words and phrases, 
playing with them and then pass on to a new 
experiment. They are insatiable seekers of 
experience, untiring in their quest for experi- 
ment, — and they learn thereby. Not every 


mickle grows into a rnuckle, and the sup- 
planting of habits, the discarding of them as 
unsatisfactory, is as marked a phenomenon 
as the formation of habits. 

So our patient allowed nothing for im- 
perfections, experimental stages, developing 
tastes in her children. She was, however, 
hardest on herself, self-critical, scolded her- 
self constantly because her house was never 
perfect, her work never done. She never had 
time to go out; she had become a veritable 
slave to a conscience that prodded her every 
time she read a book, took a nap, or went to 
a picture show. 

It was not at first obvious either to her or 
her husband that her own ideal of cleanliness 
and perfection was responsible for her neuras- 
thenia. If her "stomach was out of order 
ought she not have some stomach remedy ; if 
her nerves were out of order would the doctor 
not prescribe a nerve tonic or a sedative ?" 
The idea of a medicine for everything is still 
strong in the community and especially 
amongst dwellers in small towns, and rep- 
resents a latent belief in magic. 

In addition to such medicines as I thought 
the situation demanded, and to such advice 


as bore on her attitude to work and play, I 
hinted that dressing more fashionably might 
be of value. For the poorly dressed always 
have a feeling of inferiority in the presence 
of the better dressed, and this feeling is 
seriously disagreeable. To raise the ego- 
feeling one must remove feelings of in- 
feriority, and here was a relatively simple 
situation. This woman really cared about 
clothes, admired them, but had got it into her 
head early in life that it was sinful to be vain 
about one's looks. Though she had dis- 
carded the sin idea the notion lingered in the 
form of "unworthy of a sensible woman", 
"extravagance", etc. As she was painfully 
self-conscious in the presence of others as a 
result, this was a hidden reason for sticking 
to her home. 

This woman had a really fine intelligence, 
wanted to be well and made a gallant effort 
to change her attitude. In this she succeeded, 
became as she put it more "careless of her 
things and more careful of her people." Of 
course one cannot expect her ever to be any- 
thing but a fine housekeeper but she manages 
to be comfortable and has conquered an over- 
zealous conscience. 


Other Typical Cases 

Case VII. The ambitious woman dis- 
contented with her husband's ability. 

In the American marriage relationship the 
woman makes the home and the man makes 
the fortune. In some countries the wife is an 
active business partner. This is notably true 
in France, among the Jews in Russia, and 
many immigrant races in the United States. 
The wife may even take the leadership if her 
superiority clearly shows up. Perhaps the 
American method works well enough in a 
majority of cases, but there are superior 
women yoked to inferior men who finally 
despair of their husband's advancement, and 
who, as the phrase goes, ought to be "wearing 
the trousers" themselves. 

Mrs. D. J., thirty-nine years old, married 
fourteen years, two children, had excellent 
health before marriage. Her family, orig- 


inally poor, had been characterized by great 
success. Her brothers occupy important 
places in the business world and are wealthy. 
One of her sisters is married to a man who 
is successful in law, and the other sister is 
an executive in a department store. 

Before marriage Mrs. J. was in her brother's 
business, and at the time of her marriage 
earned a comfortable salary. She married a 
man who inherited a small business, and when 
they married she was enthusiastic over the 
prospects of this business. But unfortunately 
her husband never followed her plans ; he 
listened impatiently and went ahead in his 
own way. As a result of his conservatism 
they had not advanced at all financially. 
Though they were not poor as compared with 
the mass of people, they were poor as com- 
pared with her brothers and brother-in-law. 

In addition to the exasperation over her 
husband's attitude toward her counsel (which 
was approved by her brothers), she developed 
a disrespect for him, a feeling that he was to 
be a failure and a certain contempt crept 
into her attitude. Against this she struggled, 
but as the time went on the feeling became 
almost too strong to be disguised and caused 


many quarrels. It is probable that if her 
own brothers and sisters had not done so well 
her feeling toward her husband would not 
have reached the proportions it did, for she 
became envious of the good things they en- 
jo}-ed and to a certain extent resented her 
sisters-in-law's attitude toward her husband 
and herself as poor. The part futile jealousy 
and envy play in life will not be under- 
estimated by those who will candidly view 
their own feelings when they hear of the suc- 
cess of those who are near them. One of the 
reasons that ostentation and bragging are in 
such disfavor is because of the unpleasant 
envy and jealousy they tend involuntarily to 

With disrespect came a distaste for sexual 
relations, and here was a complicating factor 
of a decisive kind. She developed a disgust 
that brought about hysterical symptoms and 
finally she took refuge in refusal to live as a 
wife. This aroused her husband's anger and 
suspicions; he accused her of infidelity and 
had her watched. The disunion proceeded to 
the point of actual separation, and she then 
passed into an acute nervous condition, marked 
by fear, restlessness, sleeplessness, and fatigue. 


The analysis of this patient's reactions was 
difficult and as much surmised as acknowl- 
edged. With her breakdown her husband's 
affection immediately revived and his solici- 
tude and tenderness awoke her old feeling, 
together with remorse for her attitude towards 
his lack of business success. It was obvious 
to me in the few times I saw her that she was 
working out her own salvation and that no 
one's assistance was necessary after she 
understood herself. Intelligence is a prime 
essential to cure in such cases, — an ignorant 
or unintelligent woman with such reactions 
cannot be dealt with. Gradually her in- 
telligence took command, new resolves and 
purposes grew out of her illness, and it may 
confidently be said that though she never 
will be a phlegmatic observer of her husband's 
struggles she has conquered her old criticism 
and hostility. 

j Case VII. The nondomestic type and the 

That there is a nondomestic type of woman 
to-day is due to the rise of feminism and the 
fascination of industry. Where a woman has 
once been in the swirl of business, has been 
part of an organization and has tasted financial 


success, settling down may be possible, but 
is much more difficult than to the woman of 
past generations. Such a woman probably 
has never cooked a meal, or mended a stock- 
ing, or washed dishes, — and she has been 
financially independent. For love of a man 
she gives all this up, and even under the best 
of circumstances has her agonies of doubt 
and rebellion. 

Mrs. A. OX. had added to these difficulties 
the mother-in-law question. She was an 
orphan when she married, and was the private 
secretary of a business man who because she 
was efficient and intelligent and loyal gave 
her a good salary. She knew his affairs 
almost as well as he did and was treated with 
deference by the entire organization. 

She married at twenty-six a man entirely 
worthy of her love, a junior official in a bank, 
looked on as a rising man, of excellent personal 
habits and attractive physique. She re- 
signed her position gladly and went into the 
home he furnished, prepared to become a good 
wife and mother. 

Unfortunately there already was a woman 
in the house, Mr. O'L.'s mother. She was 
a good lady, a widow, and had made her 


home with the son for some years. She 
was a capable, efficient housewife, with a 
narrow range of sympathies, and with no 
ambitions. There arose at once the almost 
inevitable conflict between mother-in-law and 

Some day perhaps we shall know just why 
the husband's mother and his wife get along 
best under two roofs, though the husband's 
father presents no great difficulties. Perhaps 
in the attachment of a mother to a son there 
is something of jealousy, which is aroused 
against the other woman ; perhaps women are 
more fiercely critical of women than men are. 
Perhaps the mother, if she has a good son, is 
apt to think no woman good enough for him, 
and if she is not consulted in the choosing is 
apt to feel resentment. Perhaps to be sup- 
planted as mistress of the household or to fear 
such supplantment is the basic factor. At 
any rate, the old Chinese pictorial represen- 
tation of trouble as "two women under one 
roof" represents the state in most cases 
where mother-in-law and daughter-in-law live 

The senior Mrs. O'L. began a campaign of 
criticism against the younger woman. There 


was enough to find fault with, since the wife 
was absolutely inexperienced. But she was 
entirely new to hostile criticisr , and it im- 
peded her learning. Furtherm me was 
not inclined to try all of the mother-in-law's 
suggestions ; she had books which took dia- 
metrically the opposite point of view in some 
matters. There were some warm discussions 
between the ladies, and a spirit of rebellion 
took possession of the wife. This was em- 
phasized by the fact that sh^ found herself 
very lonely and longed secretly for the hum 
and stir of the office; for the deference and 
the courtesy she had received there. Further, 
the distracted husband, in his roles of husband 
and son, found himself displeasing both his 
wife and his mother. He tried to get the 
girl to subordinate herself, since he knew that 
this would be impossible for his mother. To 
this his wife acceded, but was greatly hurt 
in her pride, felt somehow lowered, and be- 
came quite depressed. The house seemed 
"like a prison with a cross old woman as a 
jailer", as she expressed it. 

Another factor of importance needs some 
space. The bridal year needs seclusion, on 
account of a normal voluptuousness that 


attends it. No outsider should witness the 
embraces and the kisses ; no outsider should 
be present to impede the tender talks and 
the outlet of feeling. It sometimes happens 
that the elderly have a reaction against all 
love-making; having outlived it they are 
bed thereby, they find it animal like, 
igh mdeed it is the lyric poetry of life. 
So it was in this case; the mother was a 
third party where three is more than a crowd, 
and she was a critical, disgusted third party. 
The young woman found herself taking a 
similar attitude to the love-making, found 
herself inhibiting her emotions and had a 
furtive feeling of being spied on. 

The previously strong, energetic girl quickly 
broke down. Physical strength and energy 
may come entirely from a united spirit ; a 
disunited spirit lowers the physical endurance 
remarkably. She became disloyal to matri- 
mony, rebelled against housework, and yet 
loved her husband intensely. A prey to con- 
flicting ideas and emotions, she fell into a 
circular thinking and feeling, where depressed 
thoughts cannot be dismissed and depressed 
energy follows depressed mood. Prominent 
in the symptoms were headache, sleepless- 


ness, etc., for which the neurologist was 

How to remedy this situation was to tax 
the wisdom of a Solomon. It probably would 
have remained insoluble, had not the state- 
ment I made that the main element in the 
difficulty was the mother-in-law vs. daughter- 
in-law situation come to the ears of the old 
lady. Conscientious and well-meaning, that 
lady announced her determination to take up 
her residence with a married daughter who 
already had a well-organized household, and 
whose husband was a favorite of the mother's. 
Despite the mother-in-law joke of the humor- 
ists, the mother-in-law is far more friendly to 
a daughter's husband than to a son's wife. 

This solved part of my patient's problem. 
There remained the adjustment to domestic 
life. This was hard, and though in part 
successful, it was delayed by the sterility of 
the marriage. The husband and wife agreed 
that pending a child she might well become 
active again in the larger world. Though the 
best place would have been her old work, 
pride and convention stood in the way, and 
so she entered upon more or less amateurish 
social work. Finally, perhaps as an un- 


consciously humorous compensation for her 
own troubles, she became an ardent and 
thoroughly efficient secretary to a league of 
housewives that aimed at better conditions. 
This work took up her time except for the 
supervising of a servant, and this nondomestic 
arrangement worked well since she had no 

Case VIII. The childless, neglected woman. 

It happened that two of the severest cases 
I have seen occurred, one in a Jewish woman 
and the other in a young Irish woman, with 
such an identity of symptoms and social 
domestic background that either case might 
have been interchanged for the other without 
any appreciable difference. The factors in 
the cases might simply be summarized as 
childlessness, anxiety, neglect, and loneliness, 
and in each case the main symptoms were 
anxiety, attacks of cardiac symptoms, fatigue, 
and sleeplessness. 

The young Jewish woman, thirty years of 
age, had been married since the age of twenty. 
Before marriage she worked in the needle 
trades, was well and strong and had no 
knowledge of any particular nervous or 
mental disease in her family. She married 


a man of twenty-four, who had also been 
in the tailoring business and had branched 
out in a small way in business. This busi- 
ness required him to go to work at about 
seven-thirty in the morning and he finished 
at nine-thirty in the evening. In the earlier 
years of their marriage he came home rather 
promptly at the end of his long day and the 
pair were quite happy. 

At about the third year after marriage the 
woman became quite alarmed at her continued 
sterility. She commenced to consult physi- 
cians and in the course of the next three years 
underwent three operations with no result. 
She began to brood over this, especially since 
about this time her husband began to show a 
decided lack of interest in the home. He 
would come home at twelve and later, and 
she found that he was playing cards, — in 
fact had become a confirmed gambler. When 
she first discovered this, she became greatly 
worried ; made a trip to New York where his 
people lived and induced them to bring 
pressure to bear on him for reform. This 
they did, with the result that for about six 
months he remained away from cards and 
gave more attention to his wife. 


The reform lasted only for a short period 
and then the husband plunged deeper into 
gaming than ever, and there were periods of 
three and four days at a stretch when he 
would not return home at all. At such times 
the lonely wife, who still loved her husband, 
fell into a perturbed and agitated frame of 
mind, the worse because she confided her 
difficulties to no one. When he would return, 
shamefaced and repentant, she would re- 
proach him bitterly and this would bring 
about renewed attention, gifts, etc., for a 
week or so, — and then backsliding. Finally 
even the brief spasmodic reforms grew less 
common, her reproaches were answered hotly 
or listened to with indifference, and she be- 
came "practically a widow" except for the 
occasions when the sexual feeling mastered 
them both. 

The neurosis in this case approached almost 
an insanity. The dwelling alone, the des- 
perate obsessive desire for a child to bring 
back his love and attentions and to satisfy 
her own maternal instinct, the pain the sight 
of happy couples with children gave her and 
which made her shun other women and their 
company, the fear that her husband wasun- 


faithful (which fear was probably justified), 
and the lack of any fixed or definite purpose, 
the lack of a great pride or self-sufficiency, 
brought on symptoms that necessitated her 
removal to a sanitarium. 

This of course pricked the conscience of 
her husband. He visited her frequently, 
vowed a complete change, promised to bring 
his business to the point where he would be 
able to come home at six, etc., etc. Gradually 
she improved and finally made a partial re- 

Whether or not the husband kept his prom- 
ises I cannot say. On the chances he did. 
Most confirmed gamblers, however, remain 
gamblers. The lure of excitement is more 
potent to such men than a wife whose charm 
has gone, through familiarity, through time 
itself, through the inconstancy of passion and 
love. The gambler usually knows no duty ; 
he is kind and generous but only to please 
himself. He is easily bored and his sym- 
pathies rarely stand the disagreeable long; 
he knows only one constant attraction, — 

The other woman suffered in much the 
same way except that she was fortunate 


enough finally to be deserted by her husband. 
This ended her doubts and fears, broke her 
down for a short while, and then she went 
back to industry. In this I have no doubt 
she found only an incomplete satisfaction 
for her yearnings and desires, but she had 
something to take up her time, and built up 
contacts with others in a way that was im- 
possible in her lonely home. 

Case IX. The will to power through weak- 
ness ; a case of hysteria in the home. 

This case is classic in the outspoken value 
of the symptoms to the woman. It is not 
of course typical, except as the extreme is 
typical, and that is what is usually meant. 
Roosevelt, we say, was a typical American, 
meaning that he represented in extreme de- 
velopment a certain type of man. So this 
case shows very clearly what is not so clear 
at first in many cases of conflict between 
man and wife. 

The woman in question was twenty-seven, 
of French-Canadian origin, but thoroughly 
American in appearance and speech. She 
was of a middle-class rural family and had 
married a farmer who finally had given up 
his farm and was a mechanic in a small city. 


The young woman had always been irri- 
table, egoistic, and sensitive. As a girl if 
anything happened to "shock her nerves", 
i.e. to displease her, she fainted, vomited, or 
went into "hysterics." As a result her 
family treated her with great caution and 
probably were well pleased when she married 
off their hands and left the home. 

Married life soon provided her with suffi- 
cient to displease her. Her husband drank 
but not sufficiently to be classed as a heavy 
drinker. He was a quiet, rather taciturn man, 
utterly averse to the pleasures for which his 
wife longed. She wanted to go to dances, 
to take in the theaters, to live in more expen- 
sive rooms, and especially she became greatly 
attached to a group of people of a sporty 
type whom her husband tersely called "tin- 
horn bluffs" and whom he refused to visit. 

They quarreled vigorously and the quarrels 
always ended one way, — she became sick 
in one way or other. This usually brought 
her husband around to her way of thinking, 
at least for a time, and much against his will 
he would go with her to her friends. 

Finally, however, she set her heart on 
living with these people, and he set his will 


firmly against hers. She then developed 
such an alarming set of symptoms that after 
a while the physician who asked my opinion 
had made up his mind that she had a brain 
tumor. She was paralyzed, speechless, did 
not eat and seemed desperately ill. 

The diagnosis of hysteria was established 
by the absence of any evidence of organic 
disease and by the history of the case. The 
relief of symptoms was brought about by 
means which I need not detail here, but which 
essentially consisted in proving to the patient 
that no true paralysis existed and in tricking 
her into movement and speech. 

When she was well enough to be up and 
about and to talk freely, she and her husband 
were both informed that the symptoms arose 
because her will was thwarted, and that 
part of their function was to bring the man 
to his knees. He agreed to this, but she took 
offense and refused to come any more to 
see me, — a not unnatural reaction. 

The outlook in such a case is that the couple 
will live like cats and dogs. Such a tempera- 
ment as this woman's is inborn. She is 
essentially, in the complete meaning of the 
word, unreasonable. Her nature demands a 


sympathetic attention and consideration that 
her character does not a t int. Through- 
out life she demands to 1 ire but has no 
desire to give. Nor is she powerful enough 
to take, so there arise emotional crises with 
marked disturbance in bodily energy, and 
especially symptoms that frighten the on- 
looker, such as paralyses, blindness, deafness, 
fainting spells, etc. Whatever is the source 
of these symptoms, they are frequently used 
to gain some end or purpose through the 
sympathy and discomfort of others. 

Not all hysteria, either in men or women, 
is united with such a character as this 
woman's. Sufficient stress and strain may 
bring about hysterical symptoms in a rela- 
tively normal person and short hysterical 
reactions are common in the normal woman. 
The height of cynicism may be found in the 
discovery that war causes hysteria in some 
men in much the same way that matrimony 
causes hysteria in some women. A humorous 
review of a paper on the domestic neuroses 
was entitled "Kitchen Shell Shock." But 
severe hysteria, when it arises in the house- 
wife, springs mainly from her disposition 
and not from the kitchen. 


Case X. The unfaithful husband. 

Monogamous marriage is based upon the 
assumption thac loyalty to a single male is 
moral and possible. It is probable that in 
no age has this agreement been loyally carried 
out by the husbands ; it is probable that in 
our own time the single standard of morals 
has first been strongly emphasized. With the 
rise of women into equality one of the im- 
portant demands they have made is that men 
remain as loyal as themselves. Therefore the 
reaction to unchastity or unfaithfulness on 
the part of the man is apt to be more severe 
than in the past, on the theory that where 
more is demanded failure in performance is 
felt the keener. 

The housewife, Mrs. F. C, aged thirty- 
five, is a prepossessing woman, the mother of 
two children, and has been married for nine 
years. Her health has always been fairly 
good, though in the last four years she has 
been somewhat irritable. She attributed this 
to struggle to make both ends meet, her hus- 
band being a workman with wages just over 
the border line of sufficiency. They quar- 
reled "no more than other couples do", 
were as much in love "as other couples are", 


to use her phrases. She was above her class 
in education, read what are usually called 
advanced books, was "strong for suffrage", 
etc. However she was a good housekeeper, 
devoted to her children and faithful to her 
husband. Their sexual relations were normal 
and up till six months before I saw her she 
thought herself a well-mated, rather fortunate 

Out of a clear sky came proof of long- 
continued unfaithfulness on the part of her 
"domestic" husband: a chance bill for 
women's clothes fluttered out of his pocket 
and under the bed, so that next morning 
she found it; an unbelieving moment and 
then a visit to the address on the bill, and 
proof plenty that he had been disloyal, not 
only to her but to the children, who had been 
obliged to scrimp along while he helped main- 
tain another woman. Humiliated beyond 
measure by her disaster, unable to endure 
her past memories of happiness and faith, 
with an unstable world rocking before her, 
through the revelation that a quiet, con- 
tented, loving man could be completely 
false, she found no adequate reason for 
living and became a helpless prey to her 


troubled mind. "A temporary unfaithful- 
ness, a yielding to sudden temptation" she 
could understand, but a determined plan of 
duplicity shattered her whole scheme of values. 
A very severe psychoneurosis followed, and 
her children and she were taken over by her 
parents and cared for. 

Sleeplessness was so prominent in her 
case and so evidently the central physical 
symptom that its control was difficult and 
required a regular campaign for success. 
With sleep restored and the resumption of 
eating, the most of her acute symptoms were 
passed, though a profound depression re- 

Her husband, thoroughly abashed and 
ashamed, made furtive attempts at reconcili- 
ation. These were absolutely rejected, and 
from her attitude it was obvious that no 
reconciliation was possible. "Had he not 
been found out," said the wife, "he would 
still be living with her. I can never trust 
him again; I would die before I lived with 

Little by little her pride recovered, for in 
such cases the deepest wound is to the ego, 
the self-valuation. The deepest effort of 


life is to increase that valuation by increasing 
its power and its respect by others ; the keen- 
est hurt comes with the lowering of the valu- 
ation of one's own personality. A woman 
gives herself to a man, without lowering a 
self -feeling if he is tender and faithful; if 
he holds her cheap, as by flagrant disloyalty, 
then her surrender is her most painful of 

With the recovery of pride came the 
restoration of her interest in her children, 
and her purposes reshaped themselves into 
definite plans. Part of the process in re- 
adjustment in any disordered life is to cen- 
tralize the dispersed purposes, to redirect 
the life energies. She agreed that she would 
accept aid from the husband, as his duty, but 
only for the children. For herself, as soon as 
the children were a year or so older, she 
would go back to industry and become self- 
supporting. Her plans made, her recovery 
proceeded to a firm basis, and I have no 
doubt as to its permanence. Nevertheless, 
life has changed its complexion for her, and 
there will be many moments of agony. 
These are inevitable and part of the re- 
covery process. 


I shall not attempt to settle the larger 
problem of whether she should have forgiven 
her husband and returned to him. Granting 
that his repentance was genuine, granting 
that no further lapse would occur, she would 
never be able to forget that when he deceived 
her he had acted the part of a devoted hus- 
band. She would never be able fully to 
trust him, and this would spoil their married 
happiness entirely. "For the children's 
sake," cry some readers; well, that is the 
only strong argument for return. But on the 
whole it seems to me that an honest separation, 
an honest revolt of a proud woman is better 
than a dishonest reunion, or a "patient Gri- 
selda" acceptance of gross wrong. 
Case XI. The unfaithful wife. 
In such cases as the preceding and the one 
now to be detailed, the difficulties of the 
physician are multiplied by his entrance into 
ethics. Ordinarily medicine has nothing to 
do with morals ; to the doctor saint and 
sinner are alike, and the only immorality 
is not to follow orders. To do one's duty as a 
doctor, with one's sole aim the physical health 
of the patient, may mean to advise what runs 
counter to the present-day code of morals. 


This is the true " Doctor's Dilemma. " In 
such cases discretion is the safest reaction, 
and discretion bids the physician say, "Call 
in some one else on that matter ; I am only 
a doctor.' ' 

A true neurologist must regard himself as 
something more than a physician. He needs 
be a good preacher, an astute man of the 
world, as well as something of a lawyer. 
The patient expects counsel of an intimate 
kind, expects aid in the most difficult 
situations, viz., the conflicts of health and 

Mrs. A. R., thirty -one years of age and 
very attractive, has been married since the 
age of eighteen. She has two children, and 
her husband, ten years her senior, is a man 
of whose character she says, "Every one 
thinks he is perfect." A little overstaid and 
overdignified, inclined to be pompous and 
didactic, he is kind-hearted and loyal, and 
successful in a small business. He is an 
immigrant Swiss and she is American born, 
of Swiss parentage. 

Always romantic, Mrs. A. R. became 
greatly dissatisfied with her home life. At 
times the whole scheme of things, matrimony, 


settled life, got on her nerves so that she 
wanted to scream. She was bored, and it 
seemed to her that soon she would be old 
without ever having really lived. "I married 
before I had any fun, and I have n't had any 
fun since I married except" — Except for 
the incident that broke down her health by 
swinging her into mental channels that made 
her long for the quiet domesticity against 
which she had so rebelled. Her daydreaming 
was erotic, but romantically so, not realistic. 

There are in the community adventurers 
of both sexes whose main interest in life is 
the conquest of some woman or man. The 
male sex adventurers are of two main groups, 
a crude group whose object is frank possession 
and a group best called sex-connoisseurs, who 
seek victims among the married or the hither- 
to virtuous; who plan a campaign leisurely 
and to whom possession must be preceded 
by difficulties. Frequently these gentry have 
been crude, but as satiation comes on a new 
excitement is sought in the invasion of other 
men's homes. Undoubtedly they have a 
philosophy of life that justifies them. 

Since this is not a novel we may omit the 
method by which one of these men found his 


way to the secret desires of our patient, and 
how he proceeded to develop her dissatis- 
faction into momentary physical disloyalty. 
She came out of her dereliction dazed ; 
could it be she who had done this, who had 
descended into the vilest degradation? She 
broke off all relations with the man, probably 
much to his surprise and disgust, and plunged 
into a self-accusatory internal debate that 
brought about a profound neurasthenia. 

Naturally she did not of her own accord 
speak of her unfaithfulness, — largely because 
no one knew of it. Her husband did not in 
the least suspect her ; he thought she needed 
a rest, a change, little realizing how "change" 
had broken her down. (For after all, the 
most of infidelity is based on a sort of curiosity, 
a seeking of a new stimulus, rather than true 
passion.) The truth was forced out of her 
when it was evident to me that something was 
obsessing her. 

When she had confessed her difficulty the 
question arose as to her husband. She was 
no longer dissatisfied, no longer eager for 
romance ; but could she live with him if she 
had been unfaithful? Ought she not to tell 
him ; and yet she feared to do this, feared the 


result to him, for she felt sure he would for- 
give her. In reality the conflict in her 
mind arose first from self-depreciation and 
second from indecision as to confession. 

As to the self-accusation, I told her that 
though she had been very foolish she had 
punished herself severely enough; that her 
reaction was that of an essentially moral 
person ; that an essentially immoral woman 
would have continued in her career, and at 
least would not have been so remorseful. 
As to confessing, I told her that I believed 
that if she came to peace without such a 
confession wisdom would dictate not to make 
it, and that perhaps a little romanticism was 
still present in the quixotic idea of con- 
fession. Discretion is sometimes the better 
part of veracity, and I felt sure that she 
would not find it difficult to forget her pain. 

It may be questioned whether such advice 
was ethical. I am sure no two professors 
of ethics could agree on the matter, and 
where they would disagree I chose the policy 
of expediency. Moreover, I felt certain that 
Mrs. R.'s remorse did not need the purge of 
confession to her husband, that she was not 
of that deeply fixed nature which requires 


heroic measures. Her confession to me was 
sufficient, and since it was apparent that she 
would not repeat her folly it was not necessary 
to go to extremes. 

The last two cases make pertinent some 
further remarks on sex. It has previously 
been stated that the sex field is the one in 
which arise many of the difficulties which 
breed the psychoneuroses. It would not be 
the place here to give details of cases, though 
every neurologist of experience is well aware 
of the neuroses that arise in marriage, among 
both men and women. Some day society will 
reach the plane where matters relating to 
the great function by which the world is 
perpetuated can be discussed with the free- 
dom allowed to the discussion of the details 
of nutrition. 

No one seriously doubts that women are 
breaking away from traditional ideas in these 
matters. There was a time (the Victorian 
Age) in the United States and England when 
prudery ruled supreme in the manners and 
dress of women. That this has largely dis- 
appeared is a good thing, but whether there 
is a tendency to another extreme is a matter 
where division of opinion will occur. A 


transition from long skirts to dress that will 
permit complete freedom of movement and 
resembling in a feminine way the garments 
of men would be unqualifiedly good. It would 
remove undue emphasis of sex and accentuate 
the essential human-ness of woman. But a 
transition from long skirts to short tight ones, 
impeding movement, is the transition from 
prudery to pruriency and is by no means 
a clear gain. Plenty of scope for art and 
beauty might be found in a costume of which 
pantalettes of some kind are the basis. I 
doubt if women will ever be regarded quite 
as human beings so long as they paint, wear 
fantastic coiffures, hobble along on foolish 
heels, and are clad in overtight short skirts. 
Similarly with the literature of the period. 
The so-called sex story, the sex problem, 
obsesses the writers. Nor are these frank, 
free discussions of the essential difficulties 
in the relation between man and woman. 
Usually the stories deal with the difficulties 
of the idle rich woman without children, or 
concern themselves with trivial triangles. 
In the type of interminable continued stories 
that every newspaper now carries, the 
woman's difficulties range around the most 


absurd petty jealousies, and she never seems 
to cook or sew or have any responsibility, 
and they always end so "sweetly." On the 
stage the epidemic of girl and music shows has 
quite displaced the drama. Here sex is 
exploited to the point of the risque and some- 
times beyond it. 

Sex is overemphasized by our civilization 
on its distracting side, its spicy and con- 
dimental values, and underemphasized so far 
as its realities go. The aim seems to be to 
titillate sex feeling constantly, and a preco- 
cious acquaintance with this form of stimu- 
lation is the lot of most city children. Such 
things would have no serious results to the 
housewife if they did not arouse expectations 
that marriage does not fulfill at all. This is 
the great harm of prurient clothes, literature, 
art, and stage, — it unfits people for sex 
reality. * 

In how far the delayed marriages of men 
and women are good or bad it is almost im- 
possible to decide. That unchastity increases 
with delay is a certainty, that fewer children 
are born is without doubt. Whether the 
fixation of habit makes it harder for the wife 
to settle down to the household, and the man 


less domestic, cannot be answered with yes or 
no. There seems to be no greater wisdom 
of choice shown in mature than in early 
marriages, though this would be best answered 
by an analysis of divorce records. 

That contraceptive measures have come to 
stay; that they are increasing in use, the 
declining birth rate absolutely evidences. I 
take no stock in the belief that education 
reduces fertility through some biological 
effect; where it reduces fertility it does so 
through a knowledge of cause, effect, and 
prevention. Some day it will come to pass 
that contraceptive measures will be legal, in 
view of the fact that our jurists and law 
makers are showing a decline in the size of 
their own families. When that time comes 
the discussion of means of this kind consistent 
with nervous health will be frank, and some 
part of the neurasthenia of our modern times 
will disappear. The vaster racial problems 
that will arise are not material for discussion 
in this book. 

Though not perhaps completely relevant 
to the nervousness of the housewife, it is not 
without some point to touch on the " neurosis 
of the engaged." The freedom of the engaged 


couple is part of the emancipation of youth 
in our time. Frankly, a love-making ensues 
that stops just short of the ultimate relation- 
ship, an excitement and a tension are aroused 
and perpetuated through the frequent and 
protracted meetings. Sweet as this period 
of life is, in many cases it brings about a mild 
exhaustion, and in other cases, relatively few, 
a severe neurosis. On the whole the engage- 
ment period of the average American couple 
is not a good preparation for matrimony. 
How to bring about restraint without inter- 
fering w T ith normal love-making is not an 
easy decision to make. But it would be 
possible to introduce into the teaching of 
hygiene the necessity of moderation in the 
engaged period; it would be especially of 
service to those whose engagement must be 
prolonged to be advised concerning the matter. 
Here is a place for the parents, the family 
friend, or the family physician. 

Men and women as they enter matrimony 
are only occasionally equipped with real 
knowledge as to the physiology and psychology 
of the sex life. That a great deal of domestic 
dissatisfaction and unhappiness could be ob- 
viated if wisdom and experience instructed 


the husband and wife in the matter I have 
not the slightest doubt. The first rift in 
the domestic lute often dates from difficulties 
in the intimate life of the pair, difficulties 
that need not exist if there were knowledge. 
That reason and love may coexist, that the 
beauty of life is not dependent on a senti- 
mentalized ignorance are cardinal in my code 
of beliefs. He who believes that sentiment 
disappears with enlightenment is the true 
cynic, the true pessimist. He who believes 
that intelligence and knowledge should guide 
instinct and that happiness is thus more 
certain is better than an optimist; he is a 
rationalist, a realist. 


Treatment of the Individual Cases 

It is obvious that what is largely a problem 
of the times cannot be wholly considered as an 
individual problem. Yet individual cases do 
yield to treatment (to use the slang of medi- 
cine) or at least a large proportion do. The 
minor cases in point of symptoms are very 
frequently the most stubborn, since neither 
the patient nor the family are willing to 
concede that to alter the life situation is as 
important as the taking of medicine. 

Most housewives are nervous, both in their 
own eyes and in those of their husbands, yet 
rightly they are not regarded as sick. They 
are uncomfortable, even unhappy, and the 
way out seems impossible to find. I believe 
that even with things as they are, adjust- 
ments are possible that can help the average 
woman. It is conceded that where the life 
situation involves an unalterable factor, relief 
or help may be unobtainable. 


It is necessary first of all to rule out phys- 
ical disease. To do this means a thorough 
physical study. By doing this a considerable 
number of women will be immensely helped. 
Flat feet, varicose veins, injuries to the organs 
of generation, eye strain, relaxed gastro- 
intestinal tract, and the major diseases, — 
these must be remembered as factors that 
may determine nervousness. 

With this question settled, let us assume 
that there is no such difficulty or it has been 
remedied, and we have next to consider the 
life situation of the patient. Here we enter 
into a difficult place, where knowledge of 
life and understanding of men and women, 
as well as tact, are the essentials. 

It is necessary to remedy whatever bad 
hygienic habits exist. A rich woman may 
have settled down to a deenergizing life, 
with too much time in bed, too many matinees, 
too many late nights, too many bonbons, etc. 
Aside from the psychical injuries that such a 
life produces, it is bad for "the nerves" in its 
effects upon digestion, bodily tone, and the 
sources of mood. On some simple detail of 
life, some unfortunate habit, the whole struc- 
ture of misery may rest. 


I always keep in mind an incident of some 
years ago when I lived in a small tow r n in 
Massachusetts. For some reason our fur- 
nace threw coal gas into the house in such a 
way as nearly to poison us. The landlord 
sent several plumbers down, and one after 
the other suggested drastic remedies, — a new 
chimney, a new furnace, etc. Finally the 
landlord and I investigated for ourselves. At 
the bottom of the chimney we found an in- 
conspicuous loose brick which allowed air to 
enter the chimney beneath the entrance of the 
pipe from the stove. We got ten cents' worth 
of lime and fastened the brick in firmly. A 
complete cure, where the specialists had failed. 
So there often exists some drain on the 
energy and strength of the woman which maj 
be simple and easily changed, and yet i 
critical in its significance and importance. 

An overdomestic woman may stick to^ 
closely to the house; an underdomestic one 
may go too often to movies and suffer the 
fatigue of mind and body that comes from 
over-indulgence in this most popular indoor 
sport. Carelessness about the eating and the 
care of the bowel functions may have started 
a vicious chain of things leading through irri- 


tability and fatigue into neurasthenia. We 
say human beings are all the same, but the 
range of individual susceptibility to trouble 
is such that a difficulty not important to 
most people will raise havoc with others who 
are in most ways perfectly normal. 

Look then for the bad hygiene ! Look for 
the evils of the sedentary life Look for the 
root of the trouble in lack of exercise, poor 
habits of eating, insufficient air, disturbed 
sleep ! Search for physical difficulties before 
inquiring into the psychical life. 

If poverty exists, then one may inquire into 

the amount of work done, the character of 

the home, the opportunities for recreation 

and recuperation. All or any of the factors I 

p mentioned in previous chapters may be 

cal, and the moil and turmoil of a crowded 

3ment home may be responsible. That 

i conditions do not break all women down 

s not prove that they do not break some 

women down, women with finer sensibilities, 

or lesser endurance (which often go together) . 

The most depressing problems are met among 

the poor, the cases where one can see no way 

out because the social machinery is inadequate 

to care for its victims. 


What is one to do when one meets a poor 
woman with three or four or more children, 
living in a crowded way, overworked, racked 
in her nerves by her fears, worries, and the 
disagreeable in her life, drudging from morn- 
ing till night, yearning for better things, 
despairing of getting them, tormented by 
desires and ambitions that must be thwarted ? 
"What right has a poor woman anyway to 
desires above her station, and why does not 
she resign herself to her lot?" ask the com- 
fortable. Unfortunately philosophy and res- 
ignation are difficult even for philosophers 
and saints, and much more so for the aspiring 
woman. And our American civilization 
preaches "Strive, Strive!" too constantly 
for much philosophy and resignation of an 
effective kind to be found. 

One must give tonics, prescribe rest, try to 
get social agencies interested, obtain vacations 
and convalescent care, etc. Can one purge a 
woman of futile longings and strivings, rid her 
of natural fears and even of absurd fears? 
It can be done to a limited degree, if the 
patient has intelligence and if one gives 
liberally of one's time and sympathy. But 
unfortunately the consulting room for the 


poor is in the crowded clinic, the thronged dis- 
pensary, and how is the overworked physician 
to give the time and energy necessary? 

For the time required is the least require- 
ment. To deal adequately with the neuras- 
thenic is to have unending sympathy and 
patience and an energy that is limitless. 
Without such energy or endurance the 
physician either slumps to a prescriber of 
tonics and sedatives, a dispenser of such stale 
advice as "Don't worry" and "You need a 
rest", or else himself gives out. 

In dealing with the cases in the better-to-do 
and the rich, one has more weapons in the 
armamentarium. The worry is more futile 
here, more ridiculous, and one can attack it 
vigorously. Usually it is not overwork in 
these cases ; it is monotony, boredom, dis- 
content with something or other, a vicious 
circle of depressing thoughts and emotions, 
some difficulty in the sex life, some reaction 
against the husband, a rebellion of a weak, 
futile kind against life, maladjustment of a 
temperament to a situation. 

Some difficulties, even when ascertained 
and clearly understood, are insurmountable. 
"The truth shall make ye free" is true only 


in the very largest sense. Some tempera- 
ments are inborn, and are as unchangeable 
as the nose on one's face. In such cases the 
ordinary physical therapeutics help the acute 
symptoms that flare up now and then, and 
that is as much as one may expect. 

But it is certain that in the majority of 
cases more than this may be accomplished. 
It is often a great surprise and relief to a 
woman to realize that her overconscientious- 
ness, her fussiness, her rebellion, and discon- 
tent, her reaction to something or other is back 
of her symptoms. She has feared disease of 
the brain, tumor, insanity, or has blamed her 
trouble on some other definite physical basis. 

If one deals with intelligence, explanation 
helps a great deal. The intelligent usually want 
to be convinced ; they do not ask for miracles, 
they seek counsel as well as treatment. 

It is my firm belief that the function of 
intelligence is to control instinct and emotion, 
and that temperament, if inborn, is not un- 
changeable, even at maturity. Once you 
convince a person that his or her symptoms 
are due to fear, worry, doubt, and rebellion 
you enlist the personal efforts to change. 

A new philosophy of life must be presented. 


Less fussiness, less fear, more endurance, less 
reaction to the trifles of their life are necessary. 
The aimless drifter must be given a central 
purpose or taught to seek one ; the dissatisfied 
and impatient must be asked, "Why should 
life give you all you want?" "Wliat cannot 
be remedied must be endured!" What a 
wealth of wisdom in the proverb ! One 
seeks to establish an ideal of fortitude, of 
patience, of fidelity to duty, — old-fashioned 
words, but serenity of spirit is their meaning. 
Suddenly to come face to face with one's self, 
to strip away the self-imposed disguise, to see 
clearly that jealousy, impatience, luxurious, 
and never satisfied tastes, a selfish and restless 
spirit, are back of ennui and fatigue, pains 
and aches of body and mind, is to step into a 
true self -understanding. 

If a situation demands action, even drastic 
action, "surgical" action, then that action 
must be forthcoming, even though it hurts. 
To end doubt, perplexity, to cease being 
buffeted between hither and yon, is to end an 
intolerable life situation. I have in mind 
certain domestic situations, such as the effort 
to keep up in appearance and activity with 
those of more means and ability. 


Sexual difficulties, so important and so 
common, demand the cooperation of the 
husband for remedy. He should be seen (for 
usually the wife consults the physician alone) 
and the situation gone over with him. Men 
are usually willing to help, willing to seek a 
way out. A neurasthenic wife is a sore trial 
to the patience and endurance of her husband 
and he is anxious enough to help cure her. 

Where there is conflict of other kinds the 
situation is complicated by the intricacy of 
the factors. Financial difficulties especially 
wear down the patience and endurance of 
the partners, and the physician cannot pre- 
scribe a golden cure. In prosperous times 
there is less neurasthenia than in the un- 
prosperous, just as there is less suicide. 

Sometimes it is just one thing, one difficulty, 
over which the conflict rages. I have in 
mind two such cases, where one habit of the 
husband deenergized his wife by outraging 
her pride and love. When he was induced 
to yield on this point the wife came back to 
herself, — a highly strung, very efficient self. 

In fact, the basis of treatment is the pains- 
taking study of the individual woman and 
then the painstaking adjustment of that in- 


dividual woman. It may mean the adjust- 
ment of the whole life situation to that house- 
wife, or conversely the adjustment of the 
housewife to the life situation. 

In many marital difficulties that one sees, 
not so much in practice as in contact with 
normal married couples, the trouble reminds 
one of the orang-outang in Kipling's story 
who had "too much Ego in his Cosmos." 
Marriage, to be successful, is based on a grace- 
ful recession of the ego in the cosmos of each 
of the partners. The prime difficulty is this ; 
people do not like to recede the ego. And the 
worst offenders are the ones who are deter- 
mined to stand up for the right, which usually 
is a disguised way of naming their desire. 
! One might speak of a thousand and one 
things that every man and every woman 
knows. One might speak of the death of love 
and the growth of irritation, the disappear- 
ance of sympathy, — these are the hopeless 
situations. But far more common and im- 
portant, though less tragic, is the disappear- 
ance of the little attentions, the little love- 
making, the disappearance of good manners. 
Men are not the only or the worst offenders 
in this; the nervous housewife is very apt 


to be the scold and the nag. Perhaps the 
neurasthenia of the husband arises from his 
revolt against the incessant demands of his 
wife, but that 's another story. 

At any rate, there is what seems to be a 
cardinal point of difference between men and 
women, perhaps arising from some essential 
difference in make-up, perhaps in part due to 
difference in training. An essential need of 
the average American-trained woman is sym- 
pathy, constantly expressed, constantly mani- 
fested. The average man tends to become 
matter-of-fact, the average woman finds in 
matter-of-factness the death of love. She 
acts as if she believed that the little acts of 
love and sympathy are the more important 
as manifesting the real state of feeling, that 
the major duties were of less importance. 

On this point most men and women never 
seem to agree. The man gets impatient 
over the constant demand for his attention. 
He thinks it unreasonable and childish. 
Intent upon his own struggle he is apt to think 
her affairs are minor matters. He thinks his 
wife makes mountains out of molehills and 
lacks a sense of proportion. He forgets that 
the devotion of the husband is the woman's 


anchor to windward, her grip on safety, — 
that his success and struggle are hers only 
in so far as he and she are intimate and lover- 
like. And women, even those who trust their 
husbands absolutely so far as physical loyalty 
goes, jealously watch them for the appearance 
of boredom, or lack of interest, for the falling 
off of the lover's spirit and feeling. 

After marriage the rivalry of men expresses 
itself in business more than in love. Even 
where a woman does not fear another woman 
as a rival she fears the rivalry of business, — 
and with reason. So she craves attention, 
sympathy, as well as the dull love of everyday 
life. She ought to have it; it is her rec- 
ompense for her lot, for her married life, her 
smaller interests. Now and then some great 
man intent upon a great work has some 
excuse for absorption in that work; for the 
great majority of men there is no such excuse. 
Their own affairs are also minor and are no 
more important than those of their wives. 
Fair play demands that the women they have 
immured in a home have a prior claim to their 
company, in at least the majority of the 
leisure hours. If in the time to come the 
home alters and a woman who continues to 


work marries a man who works, and they meet 
only at night, then it will be ethical for each 
to go his or her way. Marriage at present 
must mean the giving up of freedom for the 
man as well as for the woman, in the interests 
of justice and the race. 

In medicine we prescribe bitter tonics which 
have the property of increasing appetite 
and vigor. For the husband of every woman 
there is this bit of advice; sympathy and 
attention constitute a sweet tonic, which if 
judiciously administered is of incomparable 
power and efficiency. 


The Future of Woman, the Home, and 

No true sportsman ever prophesies. For 
the odds are overwhelmingly in favor of the 
prophet. If he is right, he can brag the rest 
of his days of his seer-like vision. If he is 
wrong, no one takes the trouble to reproach 
or mock him. 

Therefore I do not claim to be a prophet 
in discussing the future of woman, the home, 
and marriage. At any time just one in- 
vention may come along that will totally 
alter the face of things. Moreover we are 
now in the midst of great changes in industry, 
in social relations, in the largest matters of 
national and international nature. Men and 
women alike are involved in these changes, 
but it is impossible to judge the outcome. 
For history records many abortive refor- 
mations, many reactionary centuries and eras 


as well as successful reformations and pro- 
gressive ages. 

Whether or not it fits woman to be a house- 
wife of the traditional kind, feminism is 
certain to develop further. Women will enter 
into more diverse occupations than ever 
before, they will enter politics, they will find 
their way to direct power and action. More 
and more those who work will be specialized 
and individualized — the woman executive, 
the writer, the artist, the doctor, lawyer, 
architect, chemist, and sociologist — will resist 
the dictum "Woman's place is the Home." 
The woman of this group will either be forced 
into celibacy, or in ever-increasing numbers 
she will insist on some sort of arrangement 
whereby she can carry on her work. She 
will perhaps refuse to bear children and trans- 
form domesticity into an apartment hotel life, 
in which she and her husband eat breakfast 
and dinner together and spend the rest of 
the waking time separately, as two men might. 

Such a development, while perhaps satisfy- 
ing the ideas of progress of the feminist, will 
be bad eugenically. There will be a removal 
from the race of the value of these women, 
the intellectual members of their sex. 


Whether the work this group of women do 
will equal the value of the children they might 
have had no one can say. 

But after all, the number of women who will 
enter the professions and remain in them on 
the conditions above stated will be relatively 
small. The main function of women will 
always be childbearing. If ever there comes 
a time when the drift will be away from this 
function, then a counter-movement will start 
up to sway women back into this sphere of 
their functions. Moreover, the bulk of 
women entering industry will enter it in the 
humbler occupations and they will in the 
main be willing enough to marry and bear 
children, even in the limited way. Yet since 
they enter marriage with a wider experience 
than ever before, the conditions of marriage 
and the home must change, even though 

So on the whole we may look to an in- 
creasing individuality of woman, an increasing 
feeling of worth and dignity as an individual, 
an increasing reluctance to take up life as the 
traditional housewife. Rebellion against the 
monotony and the seclusive character of the 
home will increase rather than diminish, 


and it must be faced without prejudice and 
without any reliance on any authority, either 
of church or state, that will force women back 
to "womanly" ways of thinking, feeling or 

Sooner or later we shall have to accept 
legally what we now recognize as fact, — 
the restriction of childbearing. Whether we 
regard it as good or bad, the modern woman 
will not bear and nurse a large family. And 
the modern man, though he has his little 
joke about the modern family, is one with 
his wife in this matter. With husband and 
wife agreed there seems little to do but accept 
the situation. 

That this condition of affairs is leaving the 
peopling of the world to the backward, the 
ignorant, and the careless is at present 
accepted by most authors. One has only to 
read the serious articles on this subject in 
the journals devoted to racial biology to realize 
how deeply important the matter is. Yet 
there may be some undue alarm felt, for 
contraceptive measures are becoming so prev- 
alent in Europe, America, and Asia that all 
races will soon be on the same footing, and 
moreover all classes in society except the 


feeble-minded are learning the procedures. 
The proliflcness of the feeble-minded is indeed 
a menace, and society may find itself com- 
pelled to lower their fertility artificially. 

What will probably happen is that the one, 
two, or three-child family will be born before 
the mother's thirty-fifth year, and she will 
then or before forty become free from the 
severest burdens of the housewife. WTiat will 
she do with her time; what will the better- 
to-do woman do? Will she gradually give 
her energies to the community, or will she 
while away her time in the spurious culture 
that occupies so many club women to-day ? 

It is safe to say that women will enter far 
more largely than ever before into movements 
for the betterment of the race. Though 
their way of life may breed neurasthenia for 
some, it will have this great advantage, — 
the mother feeling will sweep into society, 
will enter politics, and social discussions. 
That we need that feeling no one will deny 
who has ever tried to enlist social energies 
for race betterment and failed while politicians 
stepped in for all the funds necessary even 
for some anti-social activities. We have 
too much legalism in our social structure 


and not near enough of the humanism that 
the socially minded mother can bring. 

Is the increasing incidence of divorce a 
revolt against domesticity ? To some extent 
yes, but where women obtain the divorce 
it is mainly a refusal to tolerate unfaithful- 
ness, desertion, incompatibility of tempera- 
ment. It does not mean that the family is 
threatened by divorce, — rather that the 
family is threatened by the conditions for 
which divorce is nowadays obtained and 
which were formerly not reasons for divorce. 
In many countries adultery on the part of the 
man, cruel and abusive treatment, chronic 
intoxication, and desertion were not grounds 
for divorce. These to-day are the grounds 
for divorce, and in the opinion of the writer 
they should invalidate a marriage. I would 
go even further and say that wherever there 
was concealed insanity or venereal disease 
the marriage should be annulled, as it is in 
some States. 

Divorce will not then diminish, despite the 
campaign against it, until the conditions 
for which it is sought are removed. Until 
that time comes, to bind two people together 
who are manifestly unhappy simply en- 


courages unfaithfulness and cruelty, and is 
itself a cruelty. 

Whether we can devise a system where 
woman's individuality and humanness can 
have scope and yet find her willing to accept 
the roles of mother and homekeeper, is a 
serious question. It seems to me certain 
that woman will continue to demand her 
freedom, regardless of her status as wife 
and mother. She will continue to receive 
more and more general and special education, 
and she will continue to find the role of the 
traditional housewife more uncongenial. Out 
of that maladaptation and the discontent and 
rebellion will arise her neurosis. 

In other words what we must seek to do] — 
those of us who are not bound by tradition 
alone but who seek to modify institutions 
to human beings rather than the reverse — 
is to find out what changes in the home and 
matrimonial conditions are necessary for the 
woman of to-day and to-morrow. 

That there has been a huge migration to the 
cities in the last century is one of its out- 
standing peculiarities. This urban move- 
ment has meant the greater concentration of 
humans in a given area, and it is therefore 


directly responsible for the apartment house. 
That is to say, there has been a trend away 
from individual homes, completely segregated 
and individualized, to houses where at least 
part of the housework was eliminated, in a 
sense was cooperative. This cooperation is in- 
creasing ; more and more houses have janitors, 
more and more houses furnish heat. In the 
highest class of apartment house the trend is 
toward permanent hotel life, with the excep- 
tion that individual housekeeping is possible. 
Because of the limited space and the desire 
of the modern well-to-do woman to escape 
as much as possible from housekeeping, be- 
cause of the smaller families (which idea has 
been fostered by landlords), the number of 
rooms and the size of the rooms have grown 
less. The kitchenette apartment is a new 
departure for those who can afford more 
room, for it is well known that the poor in 
the slums have long since lived in one or two 
rooms serving all purposes. The huge modern 
apartment house, the huge modern tenement 
house, are part first of the urban movement 
and second of that movement away from 
housekeeping which has been sketched in the 


The home has been praised as the nucleus 
of society, its center, its heart. Its virtues 
have been so unanimously extolled that one 
need but recite them. It is the embodiment 
of family, the soul of mother, father, and 
children. It is the place where morality 
and modesty are taught. In it arise the basic 
virtues of love of parents, love of children, 
love of brothers and sisters; sympathy is 
thus engendered ; loyalty has here its source. 
The privacy of the home is a refuge from 
excitement and struggle and gives rest and 
peace to the weary battler with the world. 
It is a sanctuary where safety is to be sought, 
and this finds expression in the English prov- 
erb, "Every Englishman's home is his 
castle." It is a reward, a purpose in that 
men and women dream of their own home and 
are thrilled by the thought. Throughout its 
quiet runs the scarlet thread of its sex life. 
Home is where love is legitimate and en- 

Yet the home has great faults; it is no 
more a divine institution than anything else 
human is. Without at all detracting from its 
great, its indispensable virtues, let us, as 
realists, study its defects. 


On the physical-economic side is the in- 
efficiency and waste inseparable from indi- 
vidual housekeeping. Labor-saving machin- 
ery and devices are often too expensive for 
the individual home, and so small stoves do 
the cooking and the heating, each individual 
housewife or her helper washes by hand the 
dishes of each little group. Shopping is a 
matter for each woman, and necessitates 
numberless small shops ; perhaps the biggest 
waste of time and energy lies here. The 
cooking is done according to the intelligence 
and knowledge of nutrition of each housewife, 
and housewives, like the rest of the world, 
range in intelligence from feeble-mindedness 
to genius, with a goodly number of the un- 
informed, unintelligent, and careless. Poets 
and novelists and the stage extol home 
cooking, but the doctors and dietitians know 
there are as many kinds of home cooking as 
there are kinds of homekeepers. The labor- 
atory and not the home has been the birth- 
place of the science of nutrition, and we 
have still many traditions regarding the 
merits of home cooking and feeding to break 

Take as one minor example the gorging 


encouraged on Sunday and certain holidays. 
The housewife feels it her duty to slave in a 
kitchen all Sunday morning that an over-big 
meal may be eaten in half an hour by her 
family. She encourages gluttony by feeling 
that her standing as cook is directly propor- 
tional to the heartiness of her meal. Thanks- 
giving, Christmas, — the good cheer of glut- 
tony is sentimentalized and hallowed into 
poetry and music. The table that groans 
under its good cheer has its sequence in the 
diners who groan without cheer. 

While we might further dilate on the phys- 
ical deficiencies and inefficiencies of the 
segregated home, there is a disadvantage of 
vaster importance. After all, institutionalized 
cooking is rarely satisfactory, because it lacks 
the spirit of good home cooking, the desire to 
meet individual taste without profit. It lacks 
the ideal of service. 

There are bad effects from the segrega- 
tion and the privacy of the home, even of 
the good kind. For there are very many 
bad homes; those in which drunkenness, 
immorality, quarreling, selfishness, im- 
providence, brutality, and crime are taught 
by example. After all, we like to speak too 


much in generalities — the Home, Woman, 
Man, Labor, Capital, Mankind — forgetting 
there is no such thing as "the Home." 
There are homes of all kinds with every con- 
ceivable ideal of life and training and having 
only one thing in common, — that they are 
segregated social units, based usually on the 
family relationship. Montaigne very truly 
said approximately this : "He who generalizes 
says * Hello ' to a crowd ; he who knows 
shakes hands with individuals." 

In the first place the home (to show my 
inconsistency in regard to generalizing) is 
the place where prejudice is born, nourished, 
and grown to its fullest proportions. The 
child born and reared in a home is exposed to 
the contagion of whatever silliness and preju- 
dice actuate the lives and dominate the thought 
and feeling of its parents. And the quirks and 
twists to which it is exposed affect its life either 
positively or negatively, for it either accepts 
their prejudices or develops counter-prejudices 
against them. To cite a familiar case ; it is 
traditional that some of the children brought 
up overstrictly, overcarefully, throw off as 
soon as possible and as completely as possible 
conventional morals and manners. Such per- 


sons have simply overreacted to their training, 
revolted against the prejudice of their teaching 
by building counter-prejudices. 

Further, the home fosters an anti-social 
feeling, or perhaps it would be kinder to say 
a non-social feeling. Your home-loving person 
comes in the course of time to that state of 
mind where little else is of importance ; 
the home becomes the only place where his 
sympathies and his altruistic purposes find 
any real outlet. The capitalist of the stage 
(and of real life t devoted to his 

home and family that he decorates one and the 
other with the trophies of other homes. There 
is none I to his home as the peasant, 

and there is no one so individualistic, 
intent in his own prosperity. The home 
encourages an intense altruism, but usually a 
narrow one. The feeling of warmth and 
comfort of the hearth fire when a blizzard 
rages outside too often makes us forget the 
poor fellows in the blizzard. 

Thus the home is the backbone of con- 
servatism, which is good, but it becomes 
also the basis of reactionary feeling. It is 
the people that break away from home and 
home ties who do the great thin 


When the home is quiet and harm< minus 
it is the place where great virtues are 
developed. But when it is noisy and dis- 
harmonious, then its very seelusiveness, its 
segregation, lends to the quarrels the bitter- 
ness of civil war. The intensity of feeling 
aroused is proportional to the intimacy of 
the home and not to the importance of the 
thing quarreled about. Good manners and 
that sign and symbol of largeness of spirit, 
tolerance for the opinions of others, rarely 
are born in the home. 

It is hardly realized how much quarreling, 
how much of intense emotional violence goes 
on in many homes. Its isolation and the 
absence of the restraining influence of formal- 
ity and courtesy bring the wills of the family 
members into sharp conflict. Words are 
used that elsewhere would bring the severest 
physical answer, or bring about the most 
complete disruption of friendly relations. 
Love and anger, duty and self-interest bring 
about intense inner conflict in the home, ami 
the struggle between the two generations, 
the rising and the receding, is here at its 

That courtesy to each other might be 


taught the children, might be insisted on by 
the parents is my firm belief. Love and 
intimacy need not exclude form. Manners 
and morals are not exclusive of each other. 
If the marriage ceremony included the vow 
to be polite, it might leave out almost every- 
thing else. The home should be the place 
where tolerance, courtesy, and emotional 
control are taught both by precept and 

Can the home be altered to bring in more 
of the social spirit and yet maintain its great 
virtues, its extraordinary attraction for the 
human heart ? It 's an old story that criti- 
cism, the pointing out of defect, is easy, 
while good suggestions are few and difficult 
to convert into programs for action. In 
medicine diagnosis is far ahead of treatment, 
— so in society at large. 

Any plans that have for their end a sort 
of social barracks, with men and women and 
their children living in apartments, but eat- 
ing and drinking in large groups, will meet 
the fiercest resistance from the sentiment of 
our times and cannot succeed, unless it is 
forced on us by some breakdown of the social 
structure. Nevertheless a larger cooperation, 


at least in the cities, will come. Buildings 
must be built so that a deal of individual 
labor disappears. Just as cooperative stores 
are springing up, so cooperative kitchens, 
community kitchens organized for service 
would be a great benefit. Especially for the 
poor, without servants, where the woman is 
frequently forced to neglect her own rest 
and the children's welfare because she must 
cook, would such a development be of great 
value. Unfortunately the few community 
kitchens now operating have in mind only 
the middle-class housewife and not the house- 
wife in most need, — the poor housewife. 
Here is a plan for real social service ; cooking 
for the poor of the cities, scientific, nutritious, 
tasty, at cost. Much of the work of medicine 
would be eliminated with one stroke; much 
of racial degeneracy and misery would dis- 
appear in a generation. 

That the home needs labor-saving devices 
in order that much of the disagreeable work 
may be eliminated is unquestioned. In- 
ventive genius has only given a fragmentary 
attention to the problems of the housewife. 
Most of the devices in use are far beyond the 
means of the poor and even the lower middle 


class. Furthermore, though they save labor 
many of them do not save time. The tests 
by which the good household device ought 
to be judged are these : 

First — Is it efficient ? 

Second — Is it labor saving ? 

Third — Is it time saving ? 

We need to break away from traditional 
cooking apparatus and traditional diet. The 
installation and use of tireless cookers, self- 
regulating ovens, is a first step. The dis- 
carding of most of the puddings, roasts, 
fancy dishes that take much time in the prep- 
aration and that keep the housewife in the 
kitchen would not only save the housewife 
but would also be of great benefit to her 
husband. The cult of hearty eating, which 
results in keeping a woman (mistress or maid) 
in the kitchen for three or more hours that a 
man may eat for twenty or thirty minutes is 
folly. The type of meal that either takes 
only a short time for preparation and devices 
which render the attention of the housewife 
unnecessary are ethical and healthy, both for 
the family and society. The joys of the 
table are not to be despised, and only the 
dyspeptic or the ascetic hold them in con- 


tempt ; but simplicity in eating is the very 
heart of the joy of the table. 

Elaboration and gluttony are alike in this, 
— they increase the housework and decrease 
the well-being of the diner. 

How to maintain the sweetness of the family 
spirit of the home and yet bring into it a wider 
social spirit, break down its isolated in- 
dividualistic character, is a problem I do not 
pretend to be able to solve. Ancient nations 
emphasized the social-national aspect of life 
overmuch, as for example the Spartans ; the 
modern home overemphasizes the family 
aspect. We must avoid extremes by clinging 
to the virtues and correcting the vices of the 

Alarmists are constantly raising the cry 
that marriage is declining and that society 
is thereby threatened at its very heart. 
There is the pessimist who feels that the 
"irreligion" of to-day is responsible; there 
is the one who blames feminism; and there 
is the type that finds in Democracy and 
liberalism generally the cause of the receding 
old-fashioned morality. Divorce, late mar- 
riage, and child-restriction are the manifesta- 
tions of this decadence, and the press, the 


pulpit, science, and the State all have taken 
notice of these modern phenomena, though 
with widely differing attitudes. 

That matrimony is changing cannot be 
questioned or denied. The main change is 
that woman is entering more and more as 
an equal partner whose rights the modern 
law recognizes as the ancient law did not. 
She is no longer to be classed as exemplified 
by the famous words of Petruchio, when he 
claimed his wife, the erstwhile shrew, as his 
property in exactly the same sense as any 
domestic animal, linking the wife with the 
horse, the cow, the ass, as the chattels of the 
man. The law agreed to this attitude of the 
man, the Church supported it; woman, 
strangely enough, seemed to glory in it. 

With the rise of woman into the status of a 
human being (a revolution not yet accom- 
plished in entirety) the property relationship 
weakened but lingers very strongly as a 
tradition that molds the lives of husband and 
wife. Women are still held more rigidly to 
their duties as wives than men to their duties 
as husbands, and the will of the husband still 
rules in the major affairs of life, even though 
in a thousand details the wife rules. Theoret- 


ically every man willingly acknowledges the 
importance of his wife as mother and home- 
keeper, but practically he acts as if his work 
were the really important activity of the 
family. The obedience of the wife is still 
asked for by most of the religious ceremonies 
of the times. Two great opinions are there- 
fore still struggling in the home and in society ; 
one that matrimony implies the dependence 
and essential inferiority of woman, and the 
other that the man and woman are equal 
partners in the relationship. I fully realize 
that the advocate of the first opinion will 
deny that the inferiority of woman is at all 
implied in their standpoint. But it is an 
inferior who vows obedience, it is the inferior 
who loses legal rights, it is the inferior who 
yields to another the "headship" of the home. 
The struggle of these two opinions will 
have only one outcome, the complete victory 
of the modern belief that the sexes are, all 
in all, equal, and that therefore marriage 
is a contract of equals. Meanwhile the 
struggling opinions, with the scene of con- 
flict in every home, in every heart, cause dis- 
order as all struggles do. When the victory 
is complete, then conduct will be definite 


and clear-cut, then the home will be re- 
organized in relation to the new belief, and 
then new problems will arise and be met. 
How conduct will be changed, what the new 
problems will be and how they will be met, 
I do not pretend to know. 

Meanwhile there is this to say, — that 
marriage should be guarded so that the 
grossly unfit do not marry. A thorough 
physical examination is as necessary for 
matrimony as it is for civil service, and many 
of the horrors every generation of doctors 
has witnessed could be eliminated at once 
and for all time. 

Further, if marriage is a desirable state, and 
on the whole it must be preferred to a single 
existence, surely so long as our code of morals 
remains unchanged, and so long as we be- 
lieve the race must be perpetuated, then the 
too late marriage should be discouraged. 
The ideal age for women to enter matrimony 
is from twenty-two to twenty-five ; the ideal 
age for men is from twenty-five to twenty- 
eight. It is not my province to deal at length 
with this subject, but I may state that I 
believe that continence beyond these ages 
becomes increasingly difficult, that immorality 


is encouraged, that adaptability becomes les- 
sened, and that wiser selection of mates does 
not occur. But how bring about early mar- 
riages in a time when the luxuries seem to 
have become necessities, and therefore the 
necessity of marriage is eyed more and more 
as an extravagance of the foolhardy? How 
bring about early marriage when women are 
earning pay almost equal to that of the men 
and are therefore more reluctant to enter 
matrimony unless at a high standard of 
living. The late marriage is an evil, but 
how it can be displaced by the early mar- 
riage under the present social scheme I do 
not see. 

We have considered divorce before this. 
It is not an evil but a symptom of evil ; not a 
disease in itself. It cannot be lessened or 
abolished unless we are willing to state that a 
man and a woman should live together as 
husband and wife, hating, despising, or fear- 
ing one another. We cannot countenance 
brutality, unfaithfulness, or temperamental 
mismating. It is true that divorces are often 
obtained for trivial reasons, but usually the 
partners are not adapted to one another, 
according to modern ways of thinking and 


feeling. What is commonplace in one age is 
cruelty in the next, and this is a matter not 
of argument but of expectation and feeling. 

Nothing more need be said of contraceptive 
measures than this: they are inevitably in- 
creasing in use and soon will be part of the 
average marriage. Society must recognize 
this, and the lawmakers must legalize what 
they themselves practise. 

Matrimony, the home, woman, these are 
nodal points in the network of our human 
lives. But they are not fixed centers, and 
the great weaver, Time, changes the design 
constantly. Through them run the threads 
of the great instincts, of tradition, of economic 
change, of the ideas, ideals, and activities of 
man the restless. Man will always love 
woman, woman will always love man; chil- 
dren will be born and reared, and sex con- 
flict, maladjustment, will always be secondary 
to these great facts. How men and women 
will live together, how they will arrange for 
the children, will be questions that women 
will help the world answer as well as their 
mates. That the main trend of things is for 
better, more ethical, more just relationship, 
I do not doubt. The secondary, most noisy 


changes are perhaps evil, the main primary 
change is good. 

Meanwhile in the hurly-burly of new things, 
of complex relationships, working blindly, is 
the nervous housewife. This book has been 
written that she may know herself better 
and thus move towards the light; that her 
husband may win sympathy and under- 
standing and be bound to her in a closer, better 
union, and that the physician and Society 
may seek the direct and the remote means to 
helping her. 



Alcoholism and Housewife, 157 
Anger, 88 

Beauty, Loss of, 88 

Birth control, 14-16 

Birth control measures and nervousness, 137 

Cases, Treatment of, 231-243 
Child and cartoons, 113 

and movies, 111 
Childbearing and modern woman, 15 
Children and the neurosis, 97-115 

Daydreaming, 81 
Diet and Cooking, 259 
Disagreeable, reaction to the, 90 
Divorce, 13 

Emotions, Effects of, 27-30; 42-45 
Engagement period, 229 
Extravagance of the housewife, 145 

Fear, 93 

Feminism and individualization of woman, 10-13 

Happiness and High Cost of Living, 151 
Histories of cases : 

case with bad hygiene, 183-187 

272 INDEX 

Histories of cases — Continued 

hyperaesthetic woman, 187-193 

over-rich, purposeless type, 177-181 

overworked, under-rested type, 171-177 

physically ill type, 181-183 
Holmes, Oliver Wendell, 5 
Home, aboriginal, 5 

faults of, 225 

future of, 250 

isolation of, 77 
Household conflicts, 141-159 
Housewife, hyperaesthetic type of, 51 

non-domestic type of, 61 

overconscientious type of, 53 

overemotional type of, 57 

physically ill, 69 

previously neurotic, 65 

types predisposed to nervousness, 47-73 
Housewife and abnormal child, 107 

and childbearing, 99 

and neglect, 153 

and poverty, 117 
Housewife of past generation, 3 
Housework, evolution of, 5-10 

nature of, 75 
Housework and factory, 9 
Husband and housewife, 127 
Hysteria, 35 

Jealousy and Envy, 123 

Marriage, Conflicting Views of, 127 
Marriage and sex relationship, 131-140 
Monotony, effects of, 79 

Nervousness, 17-20 
Nervousness and child hygiene, 100 

INDEX 273 

Nervousness and sick child, 104 
Neurasthenia, causes, 9 

symptoms, 20-26 
Neurasthenia and fear, 23 

Pruriency of Our Times, 275 
Psychasthenia, 31 
Psychoneuroses, 18 

Sedentary Life, Effects of, 83 

Sex and society, 139 

Subconscious, 29 

Symptoms as weapons against husband, 161 

Voltaire and Constipation, 23 

Will to Power Through Weakness, 163, 212 
Woman, arts and crafts, 6-8 
Woman, discontent of, 13 

future of, 244 

training of, 48-50 
Woman, industry and home, 8-10 
Worry, 119 

By tht Author of 44 RELIGIOX and HEALTH" 



Medical Director of Fordham University School of Sociology 

12mo. Cloth. 288 pages. 

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